Patient Referral Specialist

Position Summary

The Patient Referral Specialist is responsible for providing face- to-face quality customer service to all patients and coworkers while accurately organizing, processing, and completing all patient referrals duties. This position may serve teams to provide quality and patient-focused healthcare.

Essential Duties and Responsibilities:

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• For the coordination and timely follow-up on all patient referrals to other medical sites.
  
• Obtain request from doctor, research patient’s managed care organization for proper providers and educate patient about referral guidelines or policies.
  
• Obtain current identification for managed care, prepare certification as required and prepare authorization with patient diagnosis and request from primary care physician.
  
• Make appointments and request follow-up information.
  
• Review and explain process for referral to patient, including but not limited to what is involved, who providers are and how to get to hospital or referral specialist’s office.
  
• Maintain up-to-date knowledge of referral guidelines, active providers, necessary coverage information, insurance requirements necessary for pre-certification.
  
• Maintain adequate records for risk management on referrals to completion of patients needing to be seen outside of ACH
  
• Timely mail, fax or communicate appropriate records, certificates, and authorizations to appropriate persons for the completion of the referral process accurately and timely.
  

Supervisory Responsibility

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• None
  

Education and Experience

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• Minimum of High school Diploma or GED.
  
• 1-2 years related experience working as a receptionist or front desk in a medical or dental office.
  
• Strong computer skills with knowledge of Microsoft Word, Excel
  
• Healthcare experience
  
• Non-profit and/or community health experience
  
• EPIC EHR system experience
  
• Experience multi-tasking while providing quality customer service.
  

Preferred Skills

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• Bilingual
  

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Tasks, duties, and responsibilities, as listed in this position description, are not exhaustive. The Organization, at its sole discretion and with no prior notice, may assign other tasks, duties, and job responsibilities. Equivalent experience, skills and/or education will also be considered, so qualifications of incumbents may differ from those listed in the Position Description. The Organization, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms.