Referral Care 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 and admission to the Partial Hospital Program. Obtains proper insurance information prior to scheduling appointment and once completed contacts patient with pertinent information and ensures that all required information is forwarded to the office following practice protocols. Follows patient’s status within the referral process to ensure that the patient is contacted in a timely manner. 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. Instill Trust and Value Differences Patient and Community Focus and Collaborate.

Maintains the referral log to ensure that all outstanding referrals are followed‑up on and documents communication in patient chart.

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, adds the referral to the referral log and reviews the chart for appropriateness to the program with the director when there is question.

Maintains current knowledge of insurer referral authorization requirements and has a working understanding of the patient population and demonstrates cultural awareness and sensitivity.

Acts as a resource to practice team members regarding referral issues.

Participates in practice performance and quality improvement activities.

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 determines when the patient needs to be seen.

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. 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.

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

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