Referral Specialist - Ambulatory Patient Access - FT Days

Sky Lakes Medical Center•Klamath Falls, OR

About The Position

The Referral Specialist supports ambulatory patient access by prioritizing and processing referrals, ensuring that servicing providers receive complete demographic, insurance, and relevant clinical information. The role contacts insurance companies to confirm prior authorization requirements and provides medical information to establish the necessity of requested services. It also researches out-of-area specialists when needed. The position requires clear and professional communication, effective time management, confidentiality, and the ability to work with job-related software and adapt to new technologies. The employee is expected to keep current with job developments, work with minimal supervision, and demonstrate competence in the organization’s mission, vision, values, and strategic plan through applicable testing, skills demonstrations, service standards, and documentation review. Additional hours may be needed to reach goals.

Requirements

Ability to perform each essential job function satisfactorily, with reasonable accommodations as appropriate.
Ability to sit or stand, walk, and reach; occasionally lift and/or move up to 10 pounds.
Close vision, ability to adjust focus, and ability to view a computer monitor throughout the shift.
Ability to think clearly and focus on work tasks amid open-office distractions and competing priorities.
Clear and professional communication skills, including listening, seeking clarification, and responding to questions and feedback.
Fluency in Word, Excel, Outlook, job-related software, and computers.
Ability to maintain confidentiality in accordance with policy and regulations.

Responsibilities

Maintain consistent attendance and punctuality.
Prioritize referrals by urgency and address them in a timely manner while using time efficiently.
Ensure complete demographic, insurance, and relevant clinical information is sent to referred servicing providers.
Contact insurance companies to confirm prior authorization requirements and present necessary medical information to demonstrate medical necessity.
Research and locate out-of-area specialists as needed for referrals.
Work additional hours when necessary to reach goals.
Communicate clearly and professionally, listen and seek clarification, respond to questions and feedback, participate in meetings, proofread work, keep others informed, and choose appropriate communication methods.
Keep abreast of current developments, require minimal supervision, understand how the job relates to others, and maintain confidentiality in accordance with policy and regulations.
Use Word, Excel, Outlook, job-related software, computers, and available resources effectively; adapt to new technologies and maintain current technical skills.
Demonstrate competence in the organization’s mission, vision, values, and strategic plan through applicable proficiency testing, skills demonstrations, service standards, and documentation review.
Perform other duties as assigned.