Patient Referral Specialist

At HCA Healthcare, we are committed to caring for patients with purpose and integrity. Join Horizon Surgical Associates as a Patient Referral Specialist and help shape the patient experience.

About the role

Full time position with a Monday - Friday daytime schedule. No nights, no on-call, no weekends, and no holidays.

Responsibilities

• Process physician, hospital, and outpatient referrals.
• Schedule patients, obtain insurance authorizations, and provide guidance regarding insurance coverage.
• 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 coordinator to ensure all payor authorizations are received.
• Initiate EMR by entering demographics, referring and certifying physicians, and family information; obtain needed 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.
• Accurately communicate appointment, test, procedure information, and prep to patients and/or family members.
• 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.
• Communicate with practice staff to ensure the referral process is completed and closed.
• Submit outgoing referrals the same day, preferably with patients present to obtain optimal appointments.
• Provide weekly reports to practice leadership on referral volume, referral status, and follow-up on outstanding appointments.
• Perform related work as required.
• Practice 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.

Benefits

Horizon Surgical Associates offers a total rewards package that supports the health, life, career, and retirement of our colleagues. 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.