Patient Referral Specialist

Job Summary

Seeking a Patient Referral Specialist for our practice who processes physician, hospital, and outpatient referrals. Responsible for patient scheduling, obtaining insurance authorization, and providing appropriate guidance regarding insurance coverage.

Responsibilities

• Processes physician, hospital, and outpatient referrals.
• Responsible for patient scheduling, obtaining insurance authorization, and providing appropriate guidance regarding insurance coverage.
• Works collaboratively with all diagnostic and surgical service areas, physician offices and hospitals to ensure timeliness, accuracy and completeness when scheduling patient appointments, tests and procedures.
• Consistently provides accurate and detailed patient information to include patient demographics and medical information pertinent to appointments being scheduled to ensure patient safety and quality patient care.
• Determine insurance eligibility and authorization for medical office and/or surgical visits; or work with authorization coordinator to ensure all payor authorizations have been received.
• Initiate EMR by entering demographics, referring and certifying physicians, and family information; obtaining needed medical records from referring providers.
• Establish rapport with all offices, hospital personnel, and managed care representatives.
• Utilize EMR or other designated programs to capture and track referrals.
• Accurately and consistently communicates appointment, test, procedure information and prep to patient and/or family member.
• Adheres to privacy, compliance, and HIPPA regulations.
• Ensures the patient has a follow-up appointment with the physician to discuss outcomes, as appropriate.
• Consistently and accurately documents the date and time of appointment, tests, scan or procedure in the patient's medical record.
• Communicates as appropriate to practice staff and ensures the referral process is completed and closed.
• Outgoing referrals submitted the same day, preferably with patients present to obtain the optimal appointment.
• Weekly reporting to practice leadership on referral volume, referral status, and follow up on outstanding appointments.

Qualifications

• One year of experience in referral coordination relating to insurance provider tier levels, insurance authorizations, and out of network procedures required.
• No formal education or certifications required.

Benefits

MSO - HCA Methodist Physicians, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine servicesWellbeing support, including free counseling and referral servicesTime away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absenceSavings and retirement resources, including a 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 counselingEducation support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of NursingAdditional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

About the Company

Supports HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

Equal Opportunity Employer

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.