Patient Referral Specialist

Patient Referral Specialist

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Patient Referral Specialist with MSO - Women's Services you can be a part of an organization that is devoted to giving back!

Job Summary and Qualifications

General Summary Of Duties:

Processes physician, hospital, and outpatient referrals. Responsible for patient scheduling, obtaining insurance authorization, and providing appropriate guidance regarding insurance coverage. Essential duties and responsibilities are as follows. Other duties may be assigned.

Practice Requirements: Position eligible to be utilized in practices who see > 50 patients daily

Duties Include But Not Limited To:

• Works collaboratively with all diagnostic and surgical service areas, physician offices and hospitals to ensure timeliness, accuracy and completeness when scheduling patient appointments, tests and procedures.
• Consistently provides accurate and detailed patient information to include patient demographics and medical information pertinent to appointment being scheduled to ensure patient safety and quality patient care.
• Determine insurance eligibility and authorization for medical office and/or surgical visits; or works with authorization coordinator to ensure all payor authorizations have been received.
• Initiate EMR by entering demographics, referring and certifying physicians, and family information; obtaining needed medical records from referring providers.
• Establish rapport with all offices, hospital personnel, and managed care representatives.
• Utilize EMR or other designated programs to capture and track referrals.
• Obtains accurate and valid physician or advanced practitioner orders for all appointments, tests and procedures being scheduled.
• Accurately and consistently communicates appointment, test, procedure information and prep to patient and/or family member. Adheres to privacy, compliance and HIPPA regulations.
• Ensure patient has follow-up appointment with the physician to discuss outcomes, as appropriate.
• Consistently and accurately document the date and time of appointment, tests, scan or procedure in the patient's medical record. Communicate as appropriate to practice staff and ensures the referral process is completed and closed.
• Outgoing referrals submitted same day, preferably with patient present to obtain the optimal appointment.
• Weekly reporting to practice leadership on referral volume, referral status, and follow up on outstanding appointments.
• Performs related work as required.
• Practice and adhere to the Code of Conduct and Mission and Value Statements.

Education:

High School Diploma or GED equivalent

Experience:

One year of experience in referral coordination relating to insurance provider tier levels, insurance authorizations, and out of network procedures required

Certification/License:

None required

Knowledge, Skills And Abilities:

Knowledge of medical terminology.

Knowledge of common safety hazards and precautions to establish a safe work environment.

Establishing and maintaining effective working relationships with patients, medical staff and the public.

Must have good interpersonal skills.

Ability to communicate effectively both verbally and in writing, and keep a positive attitude with patients, peers, providers, employers, insurers, and family members.

Must be flexible and able to handle multiple tasks

Word processing and Excel experience preferred.

Good organizational skills

Benefits

MSO - Women's Services, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Be a part of an organization that invests in you! We are reviewing applications for our Patient Referral Specialist opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.