Overview

The Referral Specialist works with clinical team and must navigate and negotiate successful tracking and coordination of referrals; it requires highly technical clerical tasks, specific to an area of work.  The work includes responsibility for the preparation of specialized departmental documents; significant interpersonal staff and public contact, appropriate and professional conduct, independent judgment, discretion, and personal initiative; and use of Electronic Health Record (EHR) systems.

Responsibilities

Primary Job Functions:

Referrals:

• Track and enter all referral requests in EHR System daily
• Prioritize urgent referrals and follow entire process through to confirmed scheduled appointment
• Communicate and coordinate Health Center referral requests with outside specialists
• Request authorizations from patient’s insurance companies required by specialists
• Request authorization extensions or adjustments as requested by specialists
• Re-refer/re-schedule patients if they do not make their original referred appointment
• Provide contact information to patients asking for specific details about their appointments
• Answer, respond and document phone calls, request, and questions from patients in a timely manner
• Routinely make notification phone calls to patients throughout the referral process
• Document every step of the patients’ referral process in EHR system
• Closes the final loop in referral tracking and document patient completion in EHR
• Ensure compliance with Referral UDS and performance data measures identified.
• Communicate information via computer, phone, fax, and in writing to appropriate resources
• Respond to In-house provider questions, requests, and concerns regarding the status of patient referrals, care coordination or follow-up status
• Communicates effectively with all members of the treatment team

Other duties

• Knowledgeable of sliding fee scale for qualifying patients and can counsel and educate patients
• Assist with coverage of front desk as needed to handle patient needs
• Assist with coding and review of records for billing purposes
• Complies with Health Center’s policies and procedures
• Demonstrates professionalism, patience, and a high level of interpersonal and communication skills with patients, staff, visitors, and outside organizations
• Seeks supervision and consultation as needed.
• Accepts and employs suggestions for improvement.
• Actively works to enhance skills.
• Documents in a timely fashion per policy.
• Documents in a clear, legible, and concise manner.

Courteous and respectful towards consumers, visitors, and co-workers

• Treats consumers with care, dignity, and compassion.
• Respects consumers’ privacy and confidentiality.
• Is pleasant and cooperative with others, including consumers and families.
• Assists consumers and visitors as needed.
• Personal values don’t inhibit ability to relate and care for others.
• Is sensitive to the consumers’ needs, expectations, and individual differences.

Administrative and Other Related Duties as assigned:

• Actively participates in AltaPointe committees as required.
• Accurately completes assigned tasks in a timely manner.
• Accesses appropriate community resources according to consumers’ needs.
• Follows AltaPointe policies and procedures.
• Maintains current license and requirements for renewals and certifications, if applicable.

Qualifications

High School graduate or equivalent. Proficiency in Excel; ability to problem solve and carry out task independently; Preferred experience in medical practices to include outpatient best practices, FQHC, community mental health; coding and billing, Proficient with computer applications including Microsoft Office Suite, EHR and medical billing software, Knowledge of HIPAA.