Referral Specialist Trauma

Banner Health•Phoenix, AZ

3d•Onsite

About The Position

The Referral Specialist will provide direct support to patients by assisting with coordinating referrals. This role is crucial for ensuring patients receive continued treatment, such as specialty services and diagnostic testing, within a primary care practice. The position involves providing all necessary clinical information for payor authorization and to facilities or specialists before services are rendered. Key responsibilities include tracking and managing all referrals to close patient care gaps and providing documentation for team awareness. The schedule for this position is Monday-Friday from 8:00 am to 4:30 pm. Banner – University Medical Center Wound Care and Hyperbaric Medicine Clinic is part of the Wound Care & Hyperbaric Medicine Center at Banner – University Medical Center Phoenix, offering treatment for complicated, chronic, and non-healing wounds. The collaboration between Banner Health and the University of Arizona emphasizes patient care, education, and research.

Requirements

High school diploma/GED or equivalent working knowledge.
1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.
Knowledge of HIPAA regulations.
Strong customer service focus and willingness to problem solve.
Effective verbal and written communication skills.
Ability to manage competing priorities.
Proficient with commonly used office software.

Nice To Haves

Previous knowledge of managed care concepts.
Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience.

Responsibilities

Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements.
Acts as a liaison between patients, providers, and staff members for patients’ referral and follow up needs, providing prompt and professional service by educating patient/family and assisting patients with external resources when needed.
Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization, and communicating with receiving facilities.
Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept.
Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment, utilizing internal and external resources to seek knowledge about regulations regarding various payor sources.
Collaborates with outside referral sources and other community resources, maintaining an updated list of community resources and networking with colleagues to develop additional referral sources.
Communicates frequently with patients, physicians, staff, and third-party payers, working with and understanding managed health care concepts, and prioritizing tasks within established guidelines with moderate supervision.