Referral Specialist Jobs

About The Position

Requirements

• High school diploma or GED required
• Minimum of one (1) year of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies required
• Minimum of one (1) year of experience providing customer service in health care setting (patients and/or providers), including meeting high quality standards for services and evaluation of customer satisfaction required
• Electronic health medical record or pharmacy patient management experience
• Ability to multitask in a fast-paced environment
• Proficient in medical or pharmacy terminology, written or verbal
• Moderate skills in Microsoft Office (including Word, Excel, PowerPoint, etc.)
• Willing to travel up to 5% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)
• Excellent customer service and communication skills (both written and verbal)
• Working knowledge of medical terminology
• Ability to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlines
• Ability to complete multiple projects with time sensitive deadlines
• Ability to manage more than one priority project at a time
• Ability to work as part of a team/committee to complete assigned tasks
• Ability to exercise independent judgment and at times, work independently
• Ability to enlist cooperation of other people and department in completing assigned work and projects
• Ability to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services department
• Ability to think and act strategically and proactively
• Ability to maintain accurate records and prepare reports and correspondence related to the work
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetings
• Written Communication - Writes clearly and informatively with professional context and direction; edits work for spelling and grammar; varies writing style to meet needs of audience; presents qualitative and quantitative data effectively; able to read and interpret written information effectively.
• Become and remain proficient is all technology platforms, applications, and programs necessary to perform referral specialist duties

Nice To Haves

• Bachelor’s degree preferred
• Minimum of one (1) year of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies preferred
• General understanding of prescription benefits, insurance/payer requirements, and verification processes
• General experience working in a health care setting or services environment
• General knowledge of infusion therapy process and patient needs
• Must have scheduling flexibility and be able to work overtime (from time to time upon request)
• Careful attention to detail
• Overnight travel on occasion by car and airplane

Responsibilities

• Serve as the primary contact to a referral source (prescriber, provider, healthcare center, system, and/or practice), the patient for whom the referral is for, and the field-based sales representative associated with the referral source account.
• Navigate a new prescription via a referral from a referral source through the necessary steps to determine whether it can be serviced in the BioMatrix network of pharmacies.
• Build and maintain strong and lasting relationships with key personnel within the referral source environment using effective and timely communication ensuring their patient referrals are managed through service determination in a seamless manner.
• Build relationships with assigned referral sources and associated BioMatrix field representatives through communication and coordination with key personnel responsible for pharmacy referral activities within the healthcare setting.
• Serve as point of contact to referral source and keep necessary referral source personnel well informed of the status of referrals sent to BioMatrix for service.
• Follow-up with referral source, patient, and/or caregiver to collect all required information and data sets needed to support the referral process activities (including but not limited to patient demographic, pharmacy/medical benefits, clinical history, and/or prescription details).
• Work closely with Reimbursement Specialists and conveys outcomes of benefit investigation activities with patient when it comes to patient out of pocket costs, financial responsibility, and financial assistance options for patient support consideration.
• Work closely and communicate with Nurse Coordination team for those patients who intend to move forward with service and require in-home nurse care to be scheduled and organized around prescription fulfillment and shipping.
• Work closely and communicate with Pharmacy operations team members ensuring clinical and fulfillment resources have everything they need to successfully support the on-boarding and on-going fulfillment for a new patient referral/prescription.
• Produce written documentation representing all provider, patient, caregiver, and/or field team updates and communications in necessary systems of record.
• Understand referral turn-around time, volume, and workload metrics and goals established by leadership; use goals to effectively organize referral workload and daily activities for successful outreach and completion of referral steps needed to attain service outcomes/determination.
• Support use of technology and other innovative digital channels for internal and external stakeholder communication as directed by leadership; leverage professional and effective communication skills when utilizing technology for written correspondence with these stakeholders.
• Have strong understanding of referral and prescription management processes and available services to effectively convey status, outcomes, and next steps to team members as well as referral source, patients, and field resources as expected and needed.
• Ability to prioritize and handle multiple tasks and projects concurrently.
• General knowledge and understanding of referral profitability and reimbursement options related to referral and patient population being served.
• Support general administrative activities to navigate patient, provider, and field outreach (i.e. mailings, documentation development, scheduling of meetings/discussions, etc.).
• Act as a resource to other departments and participate in department meeting and office presentations with your expertise in this area of referral services.
• Performs related duties as requested by leadership.
• Participates in quality assurance activities and audits as directed.

Benefits

• Employees may be required to assist directly - or coordinate appropriate assistance - to ensure access to LUX Infusion’s services for individuals with disabilities, including patients, visitors, employees, or others.