Patient Services Specialist - Referrals

Texas Tech University • Amarillo, TX

2d

About The Position

This position is responsible for ensuring the smooth operation of the clinic patient flow and serving as the primary contact for patients. Responsible for scheduling appointments, preparing necessary paperwork before the patient visits, receiving patients, and maintaining records. In addition, this position is responsible for processing charges for clinic services, filing insurance claims, responding to requests for information from patients and insurance companies and maintaining related information for the department. Employees may have cash-handling responsibilities. Coordinates and processes incoming and outgoing referrals for Pediatric General Pediatrics and Pediatric Specialty clinics in a timely and accurate manner. Reviews referrals for completeness, verifies required clinical documentation, and obtains additional information as needed to facilitate timely patient scheduling. Serves as the primary liaison between TTUHSC Pediatrics, referring providers, specialty practices, hospitals, insurance companies, and patients/families regarding referral status. Utilizes the electronic medical record (EMR) and referral tracking systems to accurately document referral activity, monitor referral status, and ensure timely follow-up through completion. Tracks referral milestones including receipt, processing, scheduling, appointment completion, and communication back to referring providers when appropriate. Coordinates with the Eligibility/Authorization Specialist to ensure referrals requiring insurance authorization are processed efficiently prior to scheduled appointments. Assists patients and families in navigating the referral process while providing exceptional customer service and maintaining patient confidentiality. Communicates professionally with providers, nurses, clinic staff, and external healthcare organizations to resolve referral-related issues and remove barriers to patient care. Identifies referral delays, incomplete documentation, or workflow concerns and escalates issues through established departmental processes. Maintains knowledge of payer requirements, referral guidelines, and departmental scheduling protocols. Participates in continuous process improvement initiatives designed to improve referral turnaround times, patient access, and operational efficiency. Demonstrates proficiency with electronic medical records, referral management tools, Microsoft Office applications, and other software necessary to perform assigned duties. Performs additional duties as assigned in support of departmental operations.

Requirements

• A High School diploma or GED
• 1-year Customer Service, office, or related experience
• Proficiency with electronic medical records
• Proficiency with referral management tools
• Proficiency with Microsoft Office applications
• Proficiency with other software necessary to perform assigned duties

Nice To Haves

• Additional education may substitute for the experience requirement

Responsibilities

• Ensuring the smooth operation of the clinic patient flow
• Serving as the primary contact for patients
• Scheduling appointments
• Preparing necessary paperwork before the patient visits
• Receiving patients
• Maintaining records
• Processing charges for clinic services
• Filing insurance claims
• Responding to requests for information from patients and insurance companies
• Maintaining related information for the department
• Coordinating and processing incoming and outgoing referrals for Pediatric General Pediatrics and Pediatric Specialty clinics
• Reviewing referrals for completeness
• Verifying required clinical documentation
• Obtaining additional information as needed to facilitate timely patient scheduling
• Serving as the primary liaison between TTUHSC Pediatrics, referring providers, specialty practices, hospitals, insurance companies, and patients/families regarding referral status
• Utilizing the electronic medical record (EMR) and referral tracking systems to accurately document referral activity, monitor referral status, and ensure timely follow-up through completion
• Tracking referral milestones including receipt, processing, scheduling, appointment completion, and communication back to referring providers when appropriate
• Coordinating with the Eligibility/Authorization Specialist to ensure referrals requiring insurance authorization are processed efficiently prior to scheduled appointments
• Assisting patients and families in navigating the referral process
• Communicating professionally with providers, nurses, clinic staff, and external healthcare organizations to resolve referral-related issues and remove barriers to patient care
• Identifying referral delays, incomplete documentation, or workflow concerns and escalating issues through established departmental processes
• Maintaining knowledge of payer requirements, referral guidelines, and departmental scheduling protocols
• Participating in continuous process improvement initiatives designed to improve referral turnaround times, patient access, and operational efficiency
• Demonstrating proficiency with electronic medical records, referral management tools, Microsoft Office applications, and other software necessary to perform assigned duties
• Performing additional duties as assigned in support of departmental operations

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED