Patient Referral Specialist

HCA Healthcare · Austin, TX · 3 wk ago

On-siteAdministrativeFull-time

About the Role

As a Patient Referral Specialist with MSO - Women's Services, you will process physician, hospital, and outpatient referrals, handle patient scheduling, obtain insurance authorizations, and provide guidance regarding insurance coverage. This position is eligible for practices seeing more than 50 patients daily.

Responsibilities

Collaborate with diagnostic and surgical service areas, physician offices, and hospitals to ensure timely, accurate, and complete scheduling of patient appointments, tests, and procedures.
Provide accurate and detailed patient information, including demographics and medical details, to ensure patient safety and quality care.
Determine insurance eligibility and authorization for medical office and/or surgical visits; work with authorization coordinators to secure all payor authorizations.
Initiate EMR by entering demographics, referring and certifying physicians, and family information; obtain necessary medical records from referring providers.
Establish rapport with offices, hospital personnel, and managed care representatives.
Utilize EMR or other designated programs to capture and track referrals.
Obtain accurate and valid physician or advanced practitioner orders for all appointments, tests, and procedures.
Communicate appointment, test, procedure information, and prep to patients and/or family members accurately and consistently.
Adhere to privacy, compliance, and HIPAA regulations.
Ensure patients have follow-up appointments with physicians to discuss outcomes, as appropriate.
Document the date and time of appointments, tests, scans, or procedures in the patient's medical record accurately.
Communicate with practice staff to ensure the referral process is completed and closed.
Submit outgoing referrals the same day, preferably with the patient present to secure optimal appointments.
Provide weekly reports to practice leadership on referral volume, status, and follow-up on outstanding appointments.
Perform related work as required and adhere to the Code of Conduct and Mission and Value Statements.

Requirements

High School Diploma or GED equivalent.
One year of experience in referral coordination relating to insurance provider tier levels, insurance authorizations, and out-of-network procedures.

Skills

Knowledge of medical terminology.
Understanding of common safety hazards and precautions to establish a safe work environment.
Ability to establish and maintain effective working relationships with patients, medical staff, and the public.
Strong interpersonal skills and a positive attitude when interacting with patients, peers, providers, employers, insurers, and family members.
Flexibility and ability to handle multiple tasks.
Effective verbal and written communication skills.
Word processing and Excel experience preferred.
Good organizational skills.

Benefits

MSO - Women's Services offers a total rewards package that supports health, life, career, and retirement, including:

Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
Wellbeing support, including free counseling and referral services.
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
Savings 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 counseling.
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
Additional 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.