Referral Specialist

Description

Under the direction of the Risk Manager, serves as the primary resource for arranging and scheduling authorized patient referrals to specialists, for diagnostic procedures, and surgery. Obtains necessary pre-authorization approval and refers patients to authorized providers as required by the insurance and/or managed care organization to ensure that patients’ medical needs are met in a timely and professional manner. Supports and follows through with the vision, mission, goals, and objectives of Family Healthcare of Hagerstown.

Key Position Responsibilities and Standards:  

• Knowledge of the individual processes within the clerical area and ability to operate all office equipment.
• Responsible for appropriately processing incoming referrals, ensuring that all processes are completed utilizing the Electronic Medical Record to initiate and track all referrals within the EHR and patient record using the Order Management Template, Provider Test Action Template and Telephone Template as outlined in the Referral Process.
• Responsible for appropriately addressing incoming telephone calls. Assists other staff when needed.
• Maintains respect for employees and volunteers, and their individual commitment and contributions in support of FHH mission to provide consistent quality services.
• Performs job responsibilities with attention to safety concerns relating to staff, equipment, and the facility.

Requirements

Education: 

Graduation from high school with commercial/business courses the equivalent required. Graduation from Medical/Secretarial program preferred.

Experience: 

• Computer skills and experience required. Medical terminology required.
• EMR experience required or ability to learn with previous EMR or computer experience. Must have excellent communication skills as well as the ability to speak, write and understand the English language. Previous referral experience preferred. Must be able to work independently.
• Demonstrated competency in typing, filing, and working knowledge of medical terminology. Previous medical office and computer experience preferred. An equivalent of six months experience with insurance verification billing or registration preferred. Must be able to work independently, a self-starter who can initiate and follow through on projects.

Other: 

Good communication skills and ability to manage confidential patient information. 

CPR certified preferred.

Physical: Minimum physical effort required. Intermittent sitting with freedom of movement. Occasional walking, bending, lifting, pulling and reaching. Normal vision and hearing required.

Mental:  Frequent periods of concentration, with attention to details with frequent opportunities for diversification of tasks. Sensory requirements include the ability to articulate and comprehend the spoken English language, in addition to being able to read and write the English language.

ENVIRONMENTAL AND WORKING CONDITIONS: 

Work performed in a modern, well-equipped environment. Possible exposure to infections, viruses, and diseases. Interfaces with fellow employees, providers, and other medical offices/facilities, and patients, daily. Utilizes various types of office equipment daily; multi-line phone, fax machine, copier, shredder, and computer.