Referral Representative

ORGANIZATIONAL MISSION: The mission of Mid-State Health Center is to provide sound primary care to the community, accessible to all regardless their ability to pay.

GENERAL SUMMARY OF DUTIES: Responsible for assisting Referral Coordinator with insurance authorizations for referrals and order. Assist with daily functions of patient services department including, but not limited to; answering phones, check-in, check-out, and task messages.

ESSENTIAL FUNCTIONS:

1.    Assist with completion of all pre-certifications for radiology procedures and behavioral health appointments. Initiates appeals, and insurance referrals.

2.    Books, coordinates and schedules/reschedules patient appointments as necessary including referral appointments when required. Responsible for documenting and tracking referrals.

3.    Assist with Veteran’s Affairs authorizations, behavioral health eligibility and authorizations, and cross boarder referrals.

4.    Offer exceptional customer service, attention to detail, accurate and timely task completion as expected from a Patient Services Representative.

5.    Possible travel between and work in both office locations as needed.

6.    Communicates effectively and clearly; works effectively with co-workers as a team member and performs duties of other clerical office personnel.

7.    Verifies necessary information and records in the medical record.

8.    Answers questions regarding patient appointments and testing. Ensures patients understand all follow-up care needed by providing necessary documentation.

9.    Ensures that patients are scheduled properly and appointments are confirmed.  Accurately books, coordinates and reschedules patients’ appointments as needed.

10.  Comply with federal HIPAA regulations and practice policies for the privacy and security of patient information; explain the law and our privacy policy to patients as needed; maintain appropriate documentation of access to medical records.

11.  Politely greets, registers patient in a prompt pleasant and efficient manner. Answers telephone, screens calls, takes messages, and provides information as needed. Deals with patient’s needs expeditiously. Completes necessary paperwork such as Medical Releases, HIPAA forms, patient demographic info, etc.

12.  Oversees waiting area, coordinates patient movement, reports problems or irregularities.

13.  Supplements office staff as reception tasks permit by assisting with photocopying, computer input/typing, scheduling laboratory or radiology work as directed.

14.  Books, coordinates and schedules/reschedules patient appointments as necessary including referral appointments when required.

15.  Balances money collected from payments received and delivers to collection box at the end of shift.

16.  Maintains clean, orderly waiting area and reading materials.

17.  Attends meetings as required.

18.  Performs other duties as assigned.

EDUCATION: High school diploma or GED.

EXPERIENCE: Minimum of one year experience in customer service setting, six months receptionist experience in health care setting and experience with office equipment, previous insurance authorization experience preferred.  Knowledge of medical terminology required. Word processing and computer experience.

LICENSES and CERTIFICATIONS / KNOWLEDGE and ABILITIES:

1.    Plan, organize, delegate and supervise.

2.    Evaluate the effectiveness of existing methods and procedures; developing, analyzing, and revising processes.

3.    Operate a variety of office equipment and computer programs.

4.    Apply policies and procedures.

5.    Set priorities among multiple requests.

6.    Ability to interact with patients, medical and administrative staff, public effectively.

7.    Communicate clearly and effectively in person, in writing, or by phone.

8.    Comply with established policies and procedures.

9.    Plan and perform diversified duties requiring knowledge of patient relations and medical information management fields. 

10.  Computer literate with proficiency in Microsoft Office applications. Knowledge of database and

11.  Basic financial skills, as well as analytical skills for trend and situational analysis desired.

12.  Interact effectively with people of varied educational, socioeconomic and ethnic backgrounds, skill levels and value systems; work with frequent interruptions; be a team player.  

PHYSICAL/MENTAL DEMANDS:

Work may require hand dexterity for office machine operation, stooping and bending to files and supplies, mobility to complete errands or deliveries, or sitting for extended periods of time. Occasionally lifts and carries items weighing up to 50 pounds. Requires corrected vision and hearing to normal range. Requires manual and finger dexterity; for things such as typing, using calculator, and eye-hand coordination.

ENVIRONMENTAL/WORKING CONDITIONS:

Work is performed in an office environment. Involves frequent telephone contact with patients. Work may be stressful at times. Interaction with others is constant and interruptive. Contact involves dealing with sick people.

Health Insurance - Dental Insurance - Vision Insurance - Tuition Reimbursement - Life Insurance - 403(b) with match - FSA - EAP - Cancer insurance - accident insurance - paid time off - paid holidays - professional development assistance -