Patient Referral Specialist

About the role

Full time (Monday - Friday, days), no nights, no on-call, no weekends, no holidays. 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
• Obtains accurate and valid physician or advanced practitioner orders for all appointments, tests and procedures scheduled
• Accurately and consistently communicates appointment, test, procedure information and prep to patient and/or family member
• Adheres to privacy, compliance, and HIPPA regulations
• Ensure the patient has a follow-up appointment with the physician to discuss outcomes, as appropriate
• Consistently and accurately document the date and time of appointment, tests, scan or procedure in the patient's medical record
• Communicate as appropriate to practice staff and ensure 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
• Performs related work as required
• Practice and adhere to the Code of Conduct and Mission, and Value Statements

Qualifications

• Education: High School Diploma or GED equivalent
• Experience: One year of experience in referral coordination relating to insurance provider tier levels, insurance authorizations, and out of network procedures required
• Certification/License: None required

Benefits

• 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

Schedule

Full time, Monday - Friday, days. No nights, no on-call, no weekends, no holidays.

This response is AI-generated, for reference only.