Referrals & Authorizations Specialist I

About the Role

Bilingual Required: Spanish. Collaborates with referring physician offices to ensure referrals are completed appropriately and ensures that referrals are addressed in a timely manner.

Responsibilities

• Reviews details and expectations about the referral with patients
• Communicates effectively about the EMR system
• Needs basic knowledge of insurance information (i.e. HMO vs. PPO), classes of insurance and is able to instruct and explain to the patient
• Makes outgoing calls to patients to inform them of the preferred in network provider that they are being referred to
• Verifies if patient would like assistance in coordinating the appointment
• Verifies with patient that all information is attached to request
• Coordinates scheduling of appointments when appropriate on behalf of patients with specialist offices
• Communicates effectively and professionally with specialist offices
• Assists in sending Athena fax request to specialist office
• Ensures complete and accurate registration, including patient demographic and current insurance information
• Assembles information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist
• Demonstrates the skills of effective communication, decision-making and organization to ensure efficient job performance and job success
• Daily work is accomplished with minimal direct supervision
• Work priorities are set in order to accomplish task/goals
• Confidential matters are handled appropriately
• Provides high-level customer service to both referring physicians as well as referred patients
• Confidentiality of patient data is maintained at all times
• Workspace is maintained in an organized and professional manner
• Courteous and professional demeanor is demonstrated at all times