Referral Specialist Jobs

About The Position

Requirements

• High school diploma or GED equivalent.
• At least one year of experience in referral coordination involving insurance provider tier levels, insurance authorizations, and out-of-network procedures.
• Knowledge of medical terminology.
• Knowledge of common safety hazards and precautions for maintaining a safe work environment.
• Ability to establish and maintain effective working relationships with patients, medical staff, and the public.
• Good interpersonal skills.
• Ability to communicate effectively verbally and in writing, while maintaining a positive attitude with patients, peers, providers, employers, insurers, and family members.
• Flexibility and ability to handle multiple tasks.
• Good organizational skills.

Nice To Haves

• Word processing and Excel experience.

Responsibilities

• Coordinate scheduling of patient appointments, tests, and procedures with diagnostic and surgical service areas, physician offices, and hospitals.
• Provide accurate patient demographic and medical information relevant to scheduled appointments to support patient safety and quality care.
• Determine insurance eligibility and authorization for medical office or surgical visits, or coordinate with an authorization coordinator to confirm payor authorizations.
• Initiate the electronic medical record by entering patient demographics, referring and certifying physicians, and family information; obtain needed medical records from referring providers.
• Establish and maintain rapport with office staff, hospital personnel, and managed-care representatives.
• Use the EMR or other designated programs to capture and track referrals.
• Obtain accurate and valid physician or advanced practitioner orders for scheduled appointments, tests, and procedures.
• Communicate appointment, test, procedure, and preparation information accurately to patients or family members.
• Follow privacy, compliance, and HIPAA regulations.
• Ensure patients have follow-up appointments with physicians to discuss outcomes when appropriate.
• Document appointment, test, scan, or procedure dates and times accurately in the patient's medical record.
• Communicate with practice staff as appropriate and ensure the referral process is completed and closed.
• Submit outgoing referrals the same day, preferably while patients are present, to help obtain an optimal appointment.
• Report referral volume, referral status, and follow-up on outstanding appointments to practice leadership weekly.
• Perform related work and adhere to the Code of Conduct and Mission and Value Statements.

Benefits

• Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
• Wellbeing support, including free counseling and referral services.
• Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• 401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
• Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Fertility and family-building benefits and adoption assistance.
• Life insurance and supplemental health protection plans.
• Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.