Referral Specialist

Referral Specialist

The Referral Specialist reports to the Practice Manager. Under the general supervision, coordinates the effective and efficient patient flow in regards to scheduling appointments with specialist and testing per physician request. Obtains proper insurance authorization prior to scheduling appointment and once completed contacts patient with pertinent information and ensures that all required information is forwarded to specialist office following practice protocols. Follows patient's status within the cycle of provider care to ensure continuity of services utilizing LifeChart referral work ques. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate.

Responsibilities include scheduling/coordinating/triaging all referrals created by and sent to the practice via Lifechart work ques. Sets follow-up alarms per practice protocols and the tracking function to ensure that all outstanding referrals are followed-up on. Obtains all un-resulted consults and testing orders managed by the referral office. Alerts the ordering provider of any patient that does not keep an appointment with a specialist or testing facility. Scans into the medical record all correspondence received on patients and ensures that they are correctly labeled and forwarded to the proper ordering provider for their review. Takes messages from the referral line/fax machine, create a referral in Lifechart and forwards the information to the PCP for approval prior to sending referrals to specialist or testing facility in accordance with practice policy. Contacts patients and instructs them with not only information about the appointment but provides them with any specific instructions prior to their appointment. Maintains current knowledge of insurer referral authorization requirements and have a working understanding of the patient population and demonstrate cultural awareness and sensitivity. Acts as a resource to practice team members regarding referral issues. Participates in practice performance and quality improvement activities. Attends required meetings and trainings as directed. Performs other related duties appropriate to training and experience as assigned by physician practice manager. Knowledge of front office operations in addition to clinical knowledge for triaging referrals and determine when the patient need to be seen.

Minimum qualifications include a high school degree or the equivalent. Billing and medical knowledge. Two years of clinical referral experience required. Patient Centered Medical Home Practice (PCMH) referral experience preferred. Data entry skills and computer experience required. Strong customer service focus. Effective verbal and written communication skills. Organized and able to manage competing priorities. Able to take and follow through with delegated tasks and accountability. Demonstrated knowledge and skills necessary to provide care to patients throughout the life span with consideration of aging processes, human development stages and cultural patterns in each step of the care process.

Pay Range: $19.03-$31.39

EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location: Brown Health Medical Group - 167 Point Street Providence, Rhode Island 02903

Work Type: Monday-Friday, 8am-4:30pm

Work Shift: Day

Daily Hours: 8 hours

Driving Required: No