Referral Specialist

Heritage Health - Idaho•Coeur D'Alene, ID

52m•Onsite

About The Position

We are North Idaho’s premier provider of integrated medical, dental and behavioral health services. Our amazing care teams deliver world-class healthcare utilizing a patient directed, community-focused approach. Providing high quality, affordable Healthcare from the Heart is our passion. Our mission is to deliver a healthcare experience that provides hope, inspires change, and extends life for our patients and our community. Top reasons to join our team: Our employees are mission – minded We are passionate about providing excellent patient care Community-focused Committed to a fun and supportive team environment We offer high-quality competitive employee benefits Summary: Works closely with providers, medical assistants, and Triage nurse manager to ensure that a patient’s insurance allows them access to the services requested and to provide quality care to patients in a positive work environment.

Requirements

High School Diploma or GED.
Minimum of one year of prior outpatient healthcare experience preferred.
Proficient with computers and telephone.
Strong interpersonal skills.
Some understanding of medical procedures, specialties and coding preferred.
Required to stand, sit, and be mobile one-third to two-thirds of the time. They are required to use hands to finger, handle or feel over two-thirds of the time; while reaching with hands and arms occurs one-third of the day. Climbing or balancing, stooping, kneeling or crouching occur less than one-third of the time. Communicating by talking / hearing occurs over two-thirds of the day. Amount of time spent lifting or exerting force is about 50% for up to 10 pounds and less than one-third of the time up to 25 – 40 pounds. Rarely is there a need to lift more than 41 pounds. Must be able to manage efficient keyboard use, hear, see, speak and read.
Ability to solve complex practical problems
Positive interpersonal, communication & persuasion skills over the phone, computer & in person
Must be able to simultaneously manage several objectives and assign priorities
Deal with a wide variety of variables in situations where only limited standardization exists
Ability to interpret a variety of instructions furnished in written or oral form
Ability to work effectively under pressure to meet deadlines with a strong organization skill set for easy retrieval of information and to ensure competent closure of issues
Ability to work overtime as needed, maintain alertness & meet the controlled substance policy.
Good judgment and sound decision making and conflict management skills to inspire confidence from the customer
Manage complex analysis and use deductive reasoning

Nice To Haves

Minimum of one year of prior outpatient healthcare experience preferred.
Some understanding of medical procedures, specialties and coding preferred.

Responsibilities

Through the Electronic Health Record (EHR), receive requests for referrals.
Place the referral into the Orders section of the EHR.
Send any relevant records through the EHR to the referral provider.
Track the referral in the EHR and ensure that follow up is complete
Obtain prior authorizations from insurance companies and Medicaid/Medicare when needed.
Manage outgoing vouchers to area providers for our self-pay, Group 1 patients.
Answer and route calls from patients regarding referrals.
Communicate back to patient care teams when there are difficulties with referrals and patient follow through.
Work with supervisor to ensure that processes allow for accurate collection of data for PCMH and Meaningful Use.
Maintain positive and collegial environment and professional work ethic.
Maintain OSHA and HIPAA compliant work area.
Heritage Health staff have an active role in our Patient Centered Medical Home model of care. This role is designated as part of the Heritage Health PCMH Care Team.
Regular and predictable attendance is an essential function of this position.
Other job-related duties as assigned.
Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues.