Referral Specialist

Brown Medicine•Baltimore, MD

6d•$19 - $31•Onsite

About The Position

SUMMARY: Coordinates patient referrals and obtains benefit/coverage information, assisting with care coordination and scheduling any necessary medical testing and/or outside appointments. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Maintains ongoing tracking and appropriate documentation of incoming and outgoing patient referrals Ensures complete and accurate registration including: patient demographics, current insurance information and medical records necessary for patient appointments Assembles information concerning patient's clinical background and referral needs Per referral guidelines, provide appropriate clinical information to Specialists’ Office Contacts insurance companies to ensure prior approval requirements are met and present medical information such as history, diagnosis and prognosis when necessary Reviews details and expectations about the referral with patients Assists patients in problem solving potential issues related to the healthcare system, financial and social barriers e.g., request for interpreters, transportation services or prescription assistance Acts as the system navigator and point of contact for patients and families, allows them to have direct access for asking questions and raising concerns May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion Ensures referral requests are addressed in a timely manner Send consultation notes back to referring PCP for incoming pulmonary referrals Reminds patients of scheduled appointments via mail or phone Complies with federal and local confidentiality laws, including HIPAA, ensuring patient privacy Adheres to Brown Health Medical Group Primary Care guidelines for protecting patients’ demographic, clinical and financial information Provides coverage for other areas/ departments as needed Additional responsibilities as deemed necessary

Responsibilities

Maintains ongoing tracking and appropriate documentation of incoming and outgoing patient referrals
Ensures complete and accurate registration including: patient demographics, current insurance information and medical records necessary for patient appointments
Assembles information concerning patient's clinical background and referral needs
Per referral guidelines, provide appropriate clinical information to Specialists’ Office
Contacts insurance companies to ensure prior approval requirements are met and present medical information such as history, diagnosis and prognosis when necessary
Reviews details and expectations about the referral with patients
Assists patients in problem solving potential issues related to the healthcare system, financial and social barriers e.g., request for interpreters, transportation services or prescription assistance
Acts as the system navigator and point of contact for patients and families, allows them to have direct access for asking questions and raising concerns
May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion
Ensures referral requests are addressed in a timely manner
Send consultation notes back to referring PCP for incoming pulmonary referrals
Reminds patients of scheduled appointments via mail or phone
Complies with federal and local confidentiality laws, including HIPAA, ensuring patient privacy
Adheres to Brown Health Medical Group Primary Care guidelines for protecting patients’ demographic, clinical and financial information
Provides coverage for other areas/ departments as needed
Additional responsibilities as deemed necessary