Referral Specialist

WACO FAMILY MEDICINE•Waco, TX

41d•Onsite

About The Position

The Referral Specialist is responsible for initiating and managing all components of clinical referrals for various services. This role coordinates the flow of information between the medical clinic and the referral authorization department to ensure timely and valid referrals for clinic patients. The specialist will also schedule and notify patients of appointments, verify insurance coverage, obtain authorizations, and maintain proper documentation of referral and pre-authorization information. This position requires strong communication, organizational, and customer service skills, as well as the ability to manage multiple priorities and adhere to all regulations related to patient confidentiality.

Requirements

High school diploma or equivalent required
Computer literacy
Excel
Medical Terminology
Knowledge of ICD-10/CPT coding
Medical office billing and collection practices
Federal/state/local financial assistance programs
Strong interpersonal, oral and written communication
Excellent telephone skills and strong customer service focus
Visual and auditory accuracy
Understand/carry out simple/detailed, oral/written instructions
Memorize and retain instructions
Read and interpret detailed specifications

Nice To Haves

College Hours and/or Referral/Authorization Experience preferred
Bilingual in Spanish and English helpful

Responsibilities

Initiates and manages all components of clinical referrals for various services
Coordinates flow of information between medical clinic and referral authorization department to secure valid referrals timely for clinic patient
Schedules and notifies patients of all applicable appointments
Verifies insurance coverage and obtains authorizations, if needed, from insurance plans
Notifies registration staff to update insurance coverage as needed
Maintains proper documentation and management of the pre-authorization/referral information (faxing, scanning, etc.)
Documents clear information in Referral Notes on any transactions pertaining to referral or authorization processes using correct spelling and grammar skills
Learns and implements all policies and protocols as directed
Keeps informed of changes and updates for insurance plan policies for Authorizations and Referrals
Complies with all regulations related to patient confidentiality
Able to manage multiple priorities and manage stress appropriately
Communicates appropriately and clearly with a pleasant and professional manner to all
Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
Demonstrates a commitment to the mission, core values, and goals of Family Health Center and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion and respect
Cover duties of co-workers as needed
Other duties as assigned