Referral Specialist

Physicians Primary Care•Fort Myers, FL

About The Position

The Referral Specialist processes outgoing patient referrals, including entering referral orders with physician approval, verifying in-network referral destinations, faxing referrals with pertinent medical documentation, and documenting referral activity in the patient’s electronic medical record. The role also obtains authorizations for specialist office visits through applicable payer portals when requested. The Referral Specialist reports to the Site Supervisor and has no supervisory responsibilities. The position operates in standard medical office working conditions. It involves prolonged sitting, some bending, stooping, stretching, and walking short distances to retrieve print jobs or fax confirmations and to fax records manually. The role requires eye-hand coordination and manual dexterity to use a computer, keyboard, telephone, and multifunction office equipment, as well as normal hearing and eyesight.

Requirements

High school graduation or GED.
One year of work experience; experience in a medical office setting is preferred.
Word-processing and computer experience.
Knowledge of business office procedures.
Knowledge of grammar, spelling, and punctuation for typing patient information.
Skill in operating a computer and photocopy machine.
Ability to answer the telephone pleasantly and helpfully.
Ability to speak clearly and concisely.
Ability to read, understand, and follow oral and written instructions.
Ability to sort and file materials correctly using alphabetical or numeric systems.
Ability to establish and maintain effective working relationships with patients, employees, and the public.
Additional appropriate education may be substituted for one year of work experience.

Nice To Haves

Medical terminology knowledge is desirable.
Medical office experience is preferred.

Responsibilities

Provide friendly, courteous, and helpful customer service to internal and external customers.
Receive referral requests from specialist offices and communicate diagnosis and referral details to nurses or medical assistants for physician review and referral ordering.
Ensure referrals are accurately ordered in the EMR before processing, and review the diagnosis and specialty for an appropriate match. Family Practice referrals must be ordered by a physician or nurse; Pediatric Referral Specialists may enter orders with physician approval.
Verify the appropriate specialist destination and direct referrals to in-network providers when applicable.
Fax referrals and pertinent supporting medical records, including clinical notes, lab results, and diagnostic imaging, to the appropriate specialist office within 72 business hours.
Obtain authorization for specialist office visits upon request using applicable insurance provider portals.
Notify patients of the specialist or provider selected for STAT referrals and provide the specialist office phone number so patients can schedule appointments.
Answer incoming calls and review voicemail messages throughout the day to respond to patients and specialist offices about referral status, authorization requests, and documentation needs.
Maintain accurate, timely referral documentation, record appointment dates in the Outgoing Referral section of the patient hub, and complete referral and authorization activity efficiently.
Communicate with nurses and medical assistants through internal messaging to request additional referral details and provide information for physician review and approval.