Referral Specialist / Intake Scheduler

Psychiatry Referral And Intake Specialist

The Psychiatry Referral And Intake Specialist serves as the primary point of contact for individuals seeking services within the UKSM-W MPA Psychiatry & Behavioral Sciences Clinic. This position is responsible for reviewing all incoming referrals to ensure appropriate clinical alignment prior to scheduling and coordinating outgoing referrals to external providers or community resources when clinically appropriate. The specialist gathers preliminary patient information, manages incoming calls, and coordinates the scheduling of new patient intake appointments in a timely, professional, and patient-centered manner.

Key responsibilities include verifying insurance benefits, obtaining required authorizations, and clearly communicating financial obligations and available financial assistance options to ensure patients are fully informed prior to their visit. In addition to managing inbound referrals, this position also handles outgoing referrals to external providers and community resources when clinically appropriate, ensuring continuity of care and facilitating smooth transitions for patients.

The specialist supports individuals in navigating access to behavioral health services and directs them to alternate resources when needed. Success in this role requires strong communication skills, attention to detail, the ability to manage sensitive interactions with empathy, and a commitment to a collaborative clinical environment focused on timely, compassionate, and high-quality patient care.

Essential functions include:

• Answers and handles telephone calls in a courteous, helpful, accurate, decisive, and timely manner
• Accepts incoming referrals from providers and schedules new patient appointments for UKSM-W MPA Psychiatry & Behavioral Sciences Clinic.
• Registers new patients and maintains patient demographics and verifies that the patient's correct primary care provider is documented in the patient's electronic health record
• Performs insurance verifications and prior authorizations for incoming referrals, calculates patient estimated out-of-pocket cost, notifies patient regarding financial responsibility, provides appropriate notices, and establishes payment arrangements with patients utilizing established guidelines
• Manages incoming referral log and obtains medical records for incoming patients prior to their appointment
• Monitors provider schedules for New Patient openings and fills cancellations and reschedules with patients on waiting list to avoid gaps in schedules as assigned
• Provides support to providers, staff and patients regarding questions about referrals, insurance and prior authorizations
• Coordinates outgoing referrals to external providers or community resources when clinically appropriate, ensuring required documentation is sent and continuity of care is maintained
• Assists with various administrative tasks to support clinic operations as directed; may also be assigned to special projects
• Participates in clinic process improvement activities and team meetings to ensure efficient operations
• Reliable attendance and punctuality
• Other duties as assigned

Position qualifications include:

Education:

• High School Diploma or General Education Development (GED)

Experience:

• One to two years medical office experience required
• EHR experience preferred (we use eClinicalWorks)
• Microsoft Office experience a plus

Knowledge, skills & abilities:

Knowledge:

• Knowledge of medical ordering and referral procedures
• Knowledge of medical terminology and medical documentation principles
• Knowledge of insurance plan coverage and referral requirements (includes Medicare, Medicaid, VA and commercial insurance plans)
• Knowledge of confidentiality (HIPAA and 42 CFR Part 2) guidelines and procedures
• Knowledge of organizational emergency procedures
• Knowledge of basic computer skills and office equipment
• Knowledge of mental health terminology (preferred)

Skills:

• Skill in time management and prioritizing work
• Skill in utilizing computerized systems to gather data, analyze results, and make recommendations
• Skill in customer service and professionalism

Abilities:

• Ability to problem solve and make decisions related to medical assisting duties
• Ability to learn and master referrals, scheduling and documents within practice electronic medical records
• Ability to communicate effectively (oral & written) with patients, coworkers, residents, physicians, and external partners utilizing telephone and HIPAA compliant electronic methods
• Ability to handle upset patients and diffuse situations and manage the relationship with patient
• Ability to collaborate with leadership to improve clinical care and operations
• Ability to work well as a team and independently
• Ability to wear Personal Protective Equipment (PPE) (closed toe shoes, masks when indicated)
• Ability to be prompt and present during scheduled work hours

Competencies:

Performance evaluations are based on the individual's accuracy, accountability, adaptability, communications (oral and written), customer service, attention to detail, initiative, integrity, interpersonal skills, judgement, organization, problem solving, and time management.

Work environment:

• In person
• Outpatient clinic
• Patient-focused
• Teaching environment

Reasonable Accommodations Statement:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.