Referral Specialist

Orlando Health•St. Petersburg, FL

About The Position

The Referral Specialist is the initial point of contact for each new patient. This role is responsible for completing registrations, obtaining insurance authorizations for new patients, diagnostic testing, and hospital admissions. The specialist ensures that financial information and insurance details are verified and updates patient insurance information in billing systems as needed. They initiate the referral and authorization process for all services and visits, working closely with nursing and medical staff to facilitate optimal patient care. Additionally, they communicate with the scheduling department to confirm insurance requirements for upcoming appointments and coordinate with other departments as necessary. The role also involves providing patients with referral information for other physicians and facilities and maintaining effective communication with all internal and external customers, including PCPs, patients, and clinical departments, to obtain required authorizations. The position requires reasonably regular and punctual attendance and compliance with all Orlando Health policies and procedures. The role also involves assuming responsibility for professional development and education.

Requirements

High school graduate or equivalent education.
One (1) year of retail, customer service or health care experience.

Responsibilities

Completes registration and obtains insurance authorization for new patients, diagnostic testing and for hospital admissions.
Ensures financial information and insurance has been verified.
Updates patient insurance information in billing systems as needed.
Initiates the referral and authorization process for all services and visits.
Works closely with nursing and medical staff to facilitate optimal patient care.
Communicates with the scheduling department to verify each patient’s insurance requirements have been satisfied for upcoming appointments.
Coordinates with other departments as needed to facilitate patient’s visit.
Provides patient with referral information for other physicians and facilities.
Communicates effectively with all internal and external customers – PCP, Patient, clinical departments, etc. in order to obtain the required authorization needed for each service.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.
Assumes responsibility for professional development and education.