Referral Specialist

Referral Specialist

The Referral Specialist will coordinate all patient referrals at the request of the Providers. Will notify the patient of appointment and give any instructions if needed for patient to receive appointment date and time. Will enter all referrals into the electronic health record system (eCW), document clear notes, and track and record reports as they are received. They are to act as a liaison between the patient/provider & specialties. The Referral Specialist communicates with providers via electronic medical record, email, or telephone. The Referral Specialist will identify the insurance coverage and limitation for the patient.

Document appointments and communication with providers and patients in the EHR

Determine patient eligibility for services; arranging and scheduling medical appointments for referred care

Ensure referral results are returned to the designated Referral E-Fax within 48 hours after the consult is received, assisting with follow-up as necessary

Data Entry of Referral date, Provider, and Status of Consultation

Appropriately schedule all appointments, coordinating with the patients and the outside providers.

Efficiently notify the patient of any changes in their appointments within 24hrs, including a follow call/letter documented in EHR

Alert providers if there are any issues scheduling appointment or if the requested referral appointment is schedule for more than 3 months from date referral was generated

Alert Patient of scheduling delays and assist Patient with other Sites / or Providers for sooner appointment availability, when deemed necessary

Detail Documentation of all Patient statements and/or conclusion of Referral appointment

Verify and update patient insurance and demographic information

Contact insurance carriers to verify patient coverage as needed

Obtains pre-certification/authorization for services when applicable

Scan correspondence, consultations, and other documents to Patient's EHR.

Manages VIP's Referral Tracking Tool (eBO, eCW, excel, etc.)

Conduct outreach preventive care reminder calls to assist patients in managing their healthcare

Provide great customer service and respectful communication with patients, outside facilities and co-workers

Participate in meetings, town halls, and collaborations as designated.

Performs additional duties as assigned by supervisor.

Education: Bachelor's Degree preferred

Experience: 1-2 years of experience in program development or referral coordination within a health services agency preferred

Excellent organizational and communication skills required.

Ability to multi-task and meet assigned deadlines from a variety of management staff.

Ability to work in a fast-paced and ever-changing environment.

Leadership and/or facilitation experience with a group or team

Bilingual preferred (English/Spanish or English/French)

Public presentation and speaking skills

Extremely proficient in Microsoft Office Suite; employee is willing and able to:

Create, edit, and interpret charts, tables, and spreadsheets (via Microsoft Excel).

Effectively manage filter and sort data (via Microsoft Excel).

Create well-organized documents and outlines (via Microsoft Word).

Manage mailbox and calendar (via Microsoft Outlook).