Referral Specialist

Saint Francis Health System•Tulsa, OK

13d•Onsite

About The Position

The Referral Specialist will review, analyze and document all referral requests, obtain appropriate authorizations for all plans (managed care, Medicaid, Medicare) and coordinate the scheduling of the “referred to” specialty including communication with the Specialty Office and Patient. This role involves daily queue management, research of referral documentation, processing requests, and ensuring adherence to departmental protocols for documentation in Epic. The specialist will coordinate appointment scheduling with specialty offices and patients, maintain referral queue aging reports, and serve as a knowledgeable resource for specialty physicians and referral-related inquiries. Additionally, the role includes answering patient calls to match them with appropriate physicians based on location, insurance, and medical needs, and acting as a point of contact for internal staff regarding referral status and same-day referrals. The Referral Specialist is responsible for escalating questions, delays, and changes to supervisors and ensuring all staff are knowledgeable of available resources.

Requirements

High School Diploma or GED.
3 - 4 years related experience.
PC skills
Customer service skills
Organizational skills
Communication skills

Nice To Haves

None.

Responsibilities

Review, analyze, and document all referral requests.
Obtain appropriate authorizations for all plans (managed care, Medicaid, Medicare).
Coordinate the scheduling of the “referred to” specialty.
Communicate with the Specialty Office and Patient regarding appointments.
Access and analyze daily queue to prioritize work and schedule patients.
Research referrals to determine if all necessary documentation is included.
Assist in obtaining authorization if required for payment.
Follow departmental protocols for documentation in Epic and communication.
Work with partners to ensure daily coverage.
Arrange appointment dates and times with specialty staff/offices and diagnostic locations.
Communicate appointment information to patients.
Document appointment information for the PCP office.
Prepare weekly and monthly accounting of referral queue aging.
Locate specialty physicians and maintain desktop reference information.
Answer telephone calls from patients seeking new physicians.
Determine physician match for patients based on geographic area, insurance, and medical problem(s).
Serve as a contact point for Warren Clinic office staff with 'same day' referral questions and inquiries about patient referral status.
Ensure that questions, potential delays, and changes are brought to the attention of supervisor and/or manager.