Referral Specialist

PRIMARY DUTIES:

Initiates and manages all components of clinical referrals for various services

Coordinates flow of information between medical clinic and referral authorization department to secure valid referrals timely for clinic patient

Schedules and notifies patients of all applicable appointments

Verifies insurance coverage and obtains authorizations, if needed, from insurance plans

Notifies registration staff to update insurance coverage as needed

Maintains proper documentation and management of the pre-authorization/referral information (faxing, scanning, etc.)Documents clear information in Referral Notes on any transactions pertaining to referral or authorization processes using correct spelling and grammar skills

Learns and implements all policies and protocols as directed

Keeps informed of changes and updates for insurance plan policies for Authorizations and Referrals Complies with all regulations related to patient confidentiality

Able to manage multiple priorities and manage stress appropriately

Communicates appropriately and clearly with a pleasant and professional manner to all Demonstrates excellent judgment in handling situations not covered by written or verbal instructions

Demonstrates a commitment to the mission, core values, and goals of Family Health Center and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion and respect OTHER DUTIES:

Cover duties of co-workers as needed

Other duties as assigned PHYSICAL AND MENTAL REQUIREMENTS:

Visual and auditory accuracy

Shift length – 8 hours

Indoor setting

Continuous use of computer and calculator

Long periods of sitting

Frequent use of telephone

Continuous repetitive grasping and manipulation of both hands

Continuous conversational communication

Occasional lifting and carrying of up to 10 lbs.

Occasional standing, reaching, walking, bending, and twisting

Infrequent use of personal transportation

Occasionally working in noisy, confined areas

Understand/carry out simple/detailed, oral/written instructions

Memorize and retain instructions

Read and interpret detailed specifications

EDUCATION:

High school diploma or equivalent required, College Hours and/or Referral/Authorization Experience preferred, Bilingual in Spanish and English helpful

REPORTS TO:

Director of Billing Services

SKILLS:

Computer literacy, Excel, Medical Terminology, Knowledge of ICD-10/CPT coding, Medical office billing and collection practices, Federal/state/local financial assistance programs, Strong interpersonal, oral and written communication, Excellent telephone skills and strong customer service focus