Patient Referral Specialist

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Patient Referral Specialist with Centennial Heart, you can be a part of an organization devoted to giving back.

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.
• 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, including patient demographics and medical information pertinent to appointments being scheduled, to ensure patient safety and quality patient care.
• Determines insurance eligibility and authorization for medical office and/or surgical visits; works with authorization coordinator to ensure all payor authorizations have been received.
• Initiates EMR by entering demographics, referring and certifying physicians, and family information; obtains needed medical records from referring providers.
• Establishes rapport with all offices, hospital personnel, and managed care representatives.
• Utilizes 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 HIPAA 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.
• Submits outgoing referrals the same day, preferably with patients present to obtain the optimal appointment.
• Provides weekly reporting to practice leadership on referral volume, referral status, and follow-up on outstanding appointments.
• Performs related work as required.
• Practices and adheres 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 required.

Benefits

Centennial Heart 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 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.

Note: Eligibility for benefits may vary by location.