Referral Specialist/CHW

Roosevelt General Hospital•Portales, NM

1d•$15 - $23

About The Position

Under general supervision, the Referral Specialist/CHW represents Roosevelt General Hospital (RGH) as an exemplary hospital and clinic in the region and embodies the hospital’s mission, vision, and values. The role greets patients, families, and hospital guests and helps them navigate their hospital visits. It coordinates additional care patients may need inside or outside the facility and obtains prior authorization for testing and services. The position also supports referral and appointment workflows, assists patients with medication access, communicates with patients and providers, and provides backup to medical records and front desk registration. The Referral Specialist/CHW helps the department meet evaluation needs for the ECHO program and serves as its primary communications contact. The role requires a high school education or equivalent, effective communication, knowledge of medical procedures and terminology, basic to intermediate computer skills, and at least one year of medical office experience. Spanish speaking and prior customer service experience are preferred. Work is performed during regular hours and may require overtime or weekend hours to meet deadlines. Physical demands include prolonged sitting and walking, light to moderate work, and lifting or carrying up to 50 pounds.

Requirements

High school graduate or equivalent.
Ability to communicate effectively.
Knowledge of medical procedures and medical terminology.
Basic to intermediate computer knowledge.
One year of medical office experience required.
Typing speed of at least 40 words per minute.
Knowledge of medical insurance including Medicare, HMOs, PPOs, and commercial insurance; EMTALA regulations; and hospital billing and collections processes.
Enthusiastic and positive attitude and a genuine desire to help RGH become an exemplary hospital in the surrounding community and state.
Ability to work independently, exercise creativity, pay attention to detail, and maintain a positive attitude.
Ability to manage multiple simultaneous responsibilities and prioritize duties and tasks.
Ability to initiate communication with patients, families, and hospital visitors.
Excellent customer service and communication skills, including the ability to calm and assist distressed or agitated patients and families.
Professional demeanor and excellent public relations skills.
Excellent written skills and knowledge of medical terminology.
Dependable and punctual.
Good interpersonal skills for building relationships with colleagues at all levels.
Ability to plan and prioritize workload to meet deadlines.
Ability to work under extreme pressures.
Ability to sit approximately 4–8 hours per day and walk approximately 2 hours per day.
Ability to perform light to moderate work, lifting and carrying up to 50 pounds.
Ability to reach, bend, stoop, handle objects with hands and/or fingers, talk, hear, and see.

Nice To Haves

Spanish speaking preferred.
Previous customer service experience preferred.
Knowledge of CPT/ICD coding helpful.
Willingness to develop or improve public speaking skills.

Responsibilities

Promote the organization’s mission, vision, and values.
Greet patients, families, and hospital visitors with a positive, cheerful attitude.
Notify clients of scheduled appointments; follow up with off-site providers to confirm appointments and remind providers to submit consultation reports.
Maintain competency in obtaining and entering medical information in clinical and other information systems, including accessing information needed to complete referrals.
Screen and schedule incoming referrals.
Obtain prior authorization for diagnostic services, procedures, and specialty medications; coordinate with specialty pharmacies.
Work with clinicians to assess and address patient needs.
Assist patients in obtaining medications through prescription assistance programs and other means.
Collect data and write brief reports to meet ECHO program evaluation needs.
Answer questions from patients, clerical staff, and insurance companies.
Establish and maintain relationships with identified service providers.
Use software to code ICD and CPT codes.
Contact customers to obtain or relay account information.
Provide backup support to medical records and front desk registration.
Maintain knowledge of all RGH services.
Serve as the department’s main communications contact by answering and placing calls and taking and relaying messages for clinical staff.
Perform other duties as assigned.
Adhere to the dress code, complete annual education requirements, maintain patient confidentiality, report to work on time as scheduled, and wear identification while on duty.
Maintain regulatory requirements and comply with organizational policies and ethical business practices.
Represent the organization positively and professionally; communicate its mission, ethics, and goals.
Participate in performance improvement and continuous quality improvement activities.
Attend regular staff meetings and in-services.