Referral Specialist

Join an Organization that Puts its People First!

*Please note, this is a remote position with a schedule of Monday - Friday (8am - 5pm) - hours can be flexible

Interested in helping grow a healthcare model based on trusting relationships, joy in work, and health equity? Orchid Health might be just the place for you!

Orchid Health was founded over 10 years ago with the belief that the most effective way to improve the health of our communities is through integrated patient-centered care that takes the time to listen to and build trusting relationships with each patient. We currently see thousands of patients at our Oregon clinic locations, all supported by a talented, passionate, and dedicated staff.

Our mission is to advance a new model for community health to thrive based on relationships, joy in work, and health equity. We achieve this by leaning into our four pillars and core values:

• Challenge the Status Quo
• Cultivate Respect
• Courageously Vulnerable and Accountable

Four Pillars (in order of priority):

• Pillar 1: Employee Well-Being
• Pillar 2: Trusting Patient Relationships
• Pillar 3: Community Health
• Pillar 4: Financial Sustainability

Why work for Orchid Health?

At Orchid Health, we’re moving away from traditional top-down management to something more human: self-management. Our teams work together to make most day-to-day decisions, without a clinic manager giving direction. Instead, team members take on shared responsibilities based on their strengths, hold each other accountable, and are supported by peers, coaches, and access to clear, timely information. This structure reduces bureaucracy, supports collaboration, and makes work more meaningful. We believe that the people doing the work are best positioned to lead it, and we’ve built our organization around that belief. Orchid’s team members have abundant opportunities to expand their professional skills in a supportive environment, participate in community outreach efforts, and enjoy a robust benefits package. 

Compensation:

• $20.50 – $22.50/hour depending on experience and skills 

Benefits:

• Medical, Dental, & Vision – Orchid pays monthly premiums at 100% for team members and at least 50% for their dependents for base medical and dental plans 
• $1,000/year Wellness Benefit - for things that make you happy!
• 401(k) with a company match and financial planning and wellness resources available at no cost.
• A Continuing Education / Continuing Medical Education budget for all team members
• An Employee Assistance Program (EAP) that provides mental health support, financial planning, and lifestyle training opportunities, at no cost to employees
• 128 hours of PTO per year, annually front-loaded with tenure-based increases
• 40 hours of paid inclement weather and emergency closure leave, annually front-loaded
• 8 paid holidays, plus your birthday off!
• Free care at our clinics for team members and their families
• And more!

*Team members are eligible for benefits on the first of the month following 30 days of employment.

Orchid Health clinics are located in communities that are considered Oregon’s highest need areas when it comes to healthcare, and taking this position will be making a huge difference in a community that truly needs and appreciates its healthcare providers.

The schedule for this position is Monday – Friday, 8:00am - 5:00pm (hours can be flexible)

The Referral Specialist is one of the most important roles at Orchid Health. The Referral Specialist receives and documents patient referrals and follows Orchid Health’s referral process. Working with the patient/family, primary physician, Medical Director, and Clinic Healthcare Team, the Referral Specialist coordinates all patient referrals at the request of the providers, obtain/review pre-authorization/pre-certification, and coordinate communications with physician offices, companies, third-party payers and case managers; documenting appropriately within the medical record. 

Responsibilities:

• Ensure appropriate appointments and follow-up appointments in the clinic following referral requests/visits. 
• Ensure documentation from specialists/offices is obtained, filed in the chart and forwarded to companies/payers as appropriate. 
• Perform patient registration tasks and procedures as requested as well as assist in the clinical area as trained and requested. 
• Initiate all referral requests within 24-48 hours on business days. 
• Return all calls promptly generally within the same day. 
• Document all stages of the referral process within the EMR program (Athena) and communicate to the appropriate people regarding injury cases. 
• Coordinate and schedule specialty exams within the clinic as necessary. 
• Obtain and/or document approvals from Third-Party Payers for payment for services as directed or indicated via protocols. 
• Answer phone calls and act as a liaison between companies, patients, attorneys and work comp insurance companies. 
• Request any missing documentation from providers, once received and signed off by the medical director, scan appropriate information into the EMR program (Athena). 
• Resolves pre-certification, registration and case-related concerns prior to a patient's appointment.
• Gather pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided. 
• Use the EHR (Athena) to monitor referral orders and document all referral activities in the EHR.
• Complete prior authorizations when needed. 
• Complete appropriate referral forms. 
• Consult with providers regarding specific diagnosis information, as it relates to the referral. 
• Comply with federal, state and local regulations regarding patient confidentiality and HIPAA. 
• Ensure that the patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. 
• Perform other job-related duties, as may be assigned

Required Qualifications:

• High school diploma or GED certificate. 
• Minimum of 1 year relevant healthcare experience.
• Proficient at Excel, Word, and Outlook. 
• Excellent communication and problem-solving skills. 
• Excellent interpersonal skills, empathy and tact, when dealing with insurance companies, patients and other health care facilities. 
• Able to assume the responsibilities delegated by the Manager, to provide efficient and effective coordination of care. 
• Willing to adapt to changing situations and circumstances. 

Preferred Qualifications:

• Bilingual in Spanish. 
• Athena experience. 
• Knowledge of medical terminology 

Work Environment:

While in the clinic, team members may be exposed to viruses, disease, and infection from patients and specimens in the working environment. Team members may be required to work for extended periods of time at a computer. Team members use standard office equipment, such as computers, phones, and e-fax.

Physical Demands: 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard. The employee is frequently required to sit for extended periods of time. Specific vision abilities required by this job include close vision requirements due to computer work. Computer work is required for remote positions. Light to moderate lifting may be required. 

Travel: 

A minimum of 1-2 clinic visits per year, plus in-person meetings and events as needed. 

Employment Offer Contingencies:

Job offers are contingent upon the successful completion of a background check and drug screening. 

AAP/EEO Statement:

It is the policy of Orchid Health to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Orchid Health will provide reasonable accommodations for qualified individuals with disabilities.