CRO - Health Referral Specialist

Overview

Provides customers access to health information such as health system services, physicians referrals, appointments, class and screening registration, and other information requested. Supports the internal physician referral process through various EMR databases, including documentation, insurance verification, and scheduling. Uses designated software to document customer-related information and services. Integrates customer service with telephonic and electronic tools to ensure a positive patient experience.

• Follows steps as outlined in policies to process referrals, appointments with specialists, ancillary services and any other referral as ordered by the physician/provider with approved EMR databases.
• Documents physician practice referral interactions within the appropriate database according to standards for the physician/provider practice and the CRO.
• Refer any clinical inquiries from patients to the appropriate Health Referral Nurse.
• Answer telephone inquiries regarding SJ/C and other community resources in a timely manner.
• Assist with general inquiries from the public regarding referrals, appointments, class/screening registration and web inquiries.
• Process and document requests and actions in the CRO database accurately.
• Refer calls from patients and physicians to an RN if the request requires explanation or interpretation of clinical data.
• Accept responsibility to correct any pattern deficiency identified through quality audits, monitoring, or recordings.
• Demonstrate quality by documenting actions in appropriate databases in a responsible, accountable and ethical manner.
• Strive to hit benchmarks outlined in each key performance indicator and maintain a positive, professional attitude.
• Refer patients to the correct laboratory, imaging center, hospital or specialist; ensure precertification is obtained when needed; follow the referral process based on insurer policies and procedures.

• Minimum of 2 years College/Vocational education - Required

• 1-2 Years - Required
• Minimum of 18 months previous experience working in an office setting as a telephone customer service representative, telemarketing representative or health care representative required. Patient care experience preferred. Proficient with computers and telecommunications software and other technologies, including Microsoft Outlook, Excel, Word, Windows operating system. Database and word processing experience preferred. Meditech, call center software and other EMR experience a plus.

• None Required

• Full adherence to referral processing steps and documentation standards for physician/provider referrals and CRO databases.

• Entry level

• Full-time

• Health Care Provider

• Hospitals and Health Care