Call Center and Physician Referral Specialist

Coordinates patient care by answering incoming phone calls, scheduling, modifying and confirming patient appointments, processing incoming patient referrals, insurance verification, prior authorization responsibilities, maintaining accurate patient records, and ensuring timely communication with all parties to ensure smooth care coordination.

Requirements

• High school diploma or equivalent
• Three (3) years of experience in the health care field as a medical office assistant or medical office
• Minimum one (1) year of experience with General Surgery scheduling and referrals
• Minimum one (1) year of experience with Orthopedics scheduling and referrals
• Epic Experience
• Microsoft Excel Experience
• Customer Service Experience
• Bilingual preferred (Spanish is a plus)

Knowledge

• Scheduling and authorization procedures
• Medical terminology
• Physician medical specialties
• Community medical/health care services
• Laws, rules, and regulations governing area of assignment
• Financial system and insurance requirements
• Commercial and governmental payers, Medicare plans
• Health insurance, including HMO and PPO plans
• CPT coding
• Medicaid, Medicare, and other third-party insurance carriers billing
• Medicare rules and regulations
• Department and hospital safety practice and procedures
• Patient rights
• Age-specific patient care practices
• Infection control policies and practices
• Handling, storage, use, and disposal of hazardous materials
• Department and hospital emergency response policies and procedures

Skills

• Communicating effectively with physicians, patients, and other employees
• Customer service
• Computerized scheduling system
• Verbal and written communication
• Attention to detail and multitasking
• Verifying benefits and eligibility
• Preparing forms and applications according to laws and guidelines in area of assignment
• Preparing technical and statistical reports
• Performing technical, specialized office support work
• Using initiative and judgment within established procedural guidelines
• Setting priorities and meeting critical deadlines
• Working in a fast-paced, high-volume call center or clinic setting
• Using computers and related software applications
• Communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds
• Establishing and maintaining effective working relationships with all personnel contacted in the course of duties
• Efficient, effective, and safe use of equipment

Physical Requirements

• Mobility to work in a typical clinical setting and use standard office equipment
• Stamina to remain seated for extended periods of time and maintain concentration
• Vision to read printed materials and a computer screen
• Hearing and speech to communicate effectively in person and over the telephone
• Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.