Referral Specialist

Allergy & Ent Assoc•Houston, TX

10d•Onsite

About The Position

The Referral Coordinator plays a critical role in managing patient referrals, ensuring seamless communication between healthcare providers, insurance companies, and patients. Responsible for coordinating all new and established patient referrals, ensuring timely access to care by coordinating medical records and insurance authorization needs to facilitate expedited appointment scheduling. Requires strong organizational skills, attention to detail, and an excellent customer service mindset to facilitate efficient and timely referrals.

Requirements

High school graduate or equivalent
3 years of office experience preferred. One-year medical office experience is preferred.
Knowledge of medical terminology, HMO, PPO, medical insurance industry and general clerical procedures.
Knowledge of CPT & ICD-9/10 Coding System.
Ability to operate a multi-line telephone system.
Must be self-directed and able to work independently
Attention to detail is a must
Professional, calm and courteous demeanor
Excellent verbal and written communication skills
Proficient computer skills in Microsoft Office and Outlook. EMR knowledge preferred.
Customer Service — Knowledge of principles and processes for providing customer service; the ability to demonstrate a series of activities designed to enhance the level of both internal and external customer satisfaction.
Organization — Uses time efficiently by prioritizing and planning work activities; is methodical and efficient in structuring tasks to be accomplished.
Professional Maturity — The ability to separate emotional feelings from the real issues at hand. The ability to legitimately and objectively challenge the substance of our beliefs and biases of our observations.
Time Management — Managing one's own time and the time of others; the ability to shift back and forth between two or more activities or sources of information (such as speech, sounds, touch, or other sources).
Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Interpersonal Communication — Writes and speaks effectively based on the psychological, relational, situation, environmental and cultural dynamics within the situation
Communication — The ability to write and speak effectively using appropriate convention based on the situation; actively listens to others, asks questions to verify understanding, and uses tact and consideration when delivering feedback to others.

Responsibilities

Oversee the Referral process, including ensuring that referrals are being processed, and patients are being scheduled in a timely manner.
Dedicated to handling referrals for all practice locations, ensuring all defined key performance indicators (KPIs) are achieved (i.e. all referrals are addressed within 48 hours)
Call the patient, handle insurance authorizations, schedule all appointments, and manage registration updates
Stay in touch with patients to ensure they complete their referrals.
If a patient does not want to complete the referral, the referring physician’s office is notified to follow up with the patient
Complete prior authorization and direct patients to providers that are in-network
Entering referral orders or requests accurately and completely
Identifying and prioritizing urgent referrals
Manage prerequisite testing and information requests across a specialty
Define appointment types used to schedule referrals
Assist with incoming calls through Call Center
Communication results/following up with the referring provider
Inform “New referring physicians” to Director of Business Development
Report to Management regarding all referral issues.
Continuously assess and streamline processes to improve operational efficiency and enhance the patient experience.
Collaborate with the team to identify and propose solutions for bottlenecks, confusion and/or inefficiencies in the new patient onboarding process.
Manage online scheduling platforms, i.e.. Leading Reach, Block-It, and Zocdoc
Provides support to all Front Desk staff in all locations with authorization questions, issues, etc.
Performs other administrative tasks and/or projects required to meet performance and customer services standards.