Referral Specialist

Rochester Regional Health

1d • $19 - $24 • Onsite

About The Position

This position is responsible for scheduling and obtaining authorization/pre-certifications for various specialized testing and referrals to other MD Specialists. The role involves detailing all patient and third-party interactions in the patient’s EMR, promoting customer satisfaction, and ensuring the appropriateness of care for all assigned patients.

Requirements

• High school diploma or GED certificate required

Nice To Haves

• AAS in related field most helpful

Responsibilities

• Greets all patients, whether in person or via the telephone, with a cheerful and helpful attitude.
• Provides coordination of testing to be performed with physician, patient, facility and payer. This includes reviewing medical documents for clarity, ensuring all necessary clinical steps have been taken; works with necessary parties to obtain third-party approval.
• Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing.
• Refers self-pay and out-of-network patients to the appropriate resource to help with payment.
• Complete pre-certification/authorization with the patient’s insurance company providing any necessary documentation.
• Document authorization/pre-certification once received along with contact information of the person spoken with.
• Contacts the patient and notifies them of the scheduled procedure and all necessary instructions.
• Coordinates with the hospital or facility the arrival times of each scheduled patient and contacts them with this information.
• Assists in reviewing and revising policies and procedures pertaining to scheduling function.
• Performs other responsibilities as necessary to ensure efficiency within the practice.
• Maintains operational knowledge of department equipment: telephones, computers, faxes, copier, printers, etc.
• Provides age and culturally appropriate assessment, interpretation of clinical and laboratory data and develops and implements age appropriate interventions and plans of care including education within the parameters of his/her position responsibilities and licensure.
• Ensure staff considers age related concerns such as: hearing, vision, speech and level of understanding, when interacting with patients, employees and families.

Benefits

• Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials. It’s vision is to lead the evolution of healthcare to enable every member of the communities it serves to enjoy a better, healthier life.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED