Referral Specialist

POSITION SUMMARY

The role of the Referral Specialist is to provide administrative support to the medical staff and coordinate referrals ordered by a KVHC provider or received from an external organization. The referral specialist will facilitate all communication related to referrals including prior authorization, patient education with reference to referring specialist, and utilize their organizational skills to assist with facilitating patient care.

RESPONSIBILITIES

1. Answer incoming referral telephone calls.

2. Process all referral requests within EHR.

3. Resolve pre-certification, registration and case-related concerns prior to patient’s specialty appointments.

4. Document communications, actions, and other data related to referrals into the patients’ record.

5. Act as a liaison between providers, hospitals, specialty offices, insurance carriers and patients regarding referrals. 6. Schedule necessary appointments with specialist or testing sites.

7. Send necessary records or documents to specialist, testing site, and/or insurance company.

8. Provide patient education on referral tests and procedures.

9. Notify patients of all appointments and distribute necessary documents/forms.

10. Perform follow-up tasks for all consults and testing orders referred out.

11. Participates in the Care Team as outlined in Team Approach to Care Protocol.

12. New employee immunization and vaccination tracking.

13. Performs additional duties or projects as assigned by the Health Records Manager.

14. Adheres to all KVHC policies and protocols.

15. Complies with all safety rules and protocols. Reports all incidents, regardless of severity, immediately to their supervisor and completes an incident report and investigation form, which will be forwarded to Human Resources within 24 hours of the incident.

16. Conducts themselves as a good steward in the communities served by KVHC; represents the organization at outreach activities as needed.

17. Actively participates as committee member as assigned by the Chief Executive Officer.

18. Interacts harmoniously and effectively with others. Focusing on the attainment of organization goals and objectives through a commitment to team work.

19. Conforms to acceptable attendance and punctuality standards as expressed in the employee handbook.

20. Abides by the organization’s compliance program and requirements.

21. At times you may be faced with challenges that may impact patient care. Addressing these challenges may not be in your job description, however Katahdin Valley Health Center encourages each team member to go above and beyond to address the patients’ needs in the moment. Employees have the autonomy to see the care experience through from A to Z to show our patients KVHC C.A.R.E.S.

PROFESSIONAL EXPECTATIONS

1. Admit mistakes or missteps openly, own your own behavior, forgive one another, and model vulnerability and humility.

2. Keep discussions about team members, subordinates, and colleagues as well as challenges in the workplace, positive, constructive, and factual.

3. Be mindful of employee confidentiality even among peers, and particularly where an issue involves a peer.

4. Only say what you would be willing to say to someone directly.

5. Whenever possible, speak directly to the person with whom you are having a disagreement or a challenge. Challenge yourself to engage in these discussions. Do not avoid constructive conflict.

6. Work with your supervisor or HR when you need to process a performance or behavioral situation with a colleague or subordinate to determine next steps.

7. It is always okay, and usually preferable, to pause, and take time to reflect before reacting to a situation.

EDUCATION AND EXPERIENCE

1. High School or equivalent diploma, or equivalent combination of education and experience.

2. Excellent computer skills including working knowledge of Microsoft Office products including Word and Excel.

3. The ability to work independently and collaboratively in a team setting with minimal supervision and react to change productively.

4. Excellent interpersonal (customer service) skills, critical thinking skills, time management skills, and problem solving skills.

5. Must be able to work under pressure in a busy healthcare office setting.

6. Must possess the ability to communicate effectively, both verbally and in writing.

7. The ability to follow all safety rules and regulations

8. Must possess a clean criminal and DHHS background.

9. Must possess the ability and means to travel between clinics, as needed.

10. Valid State of Maine Driver’s license and the ability to be insured by KVHC’s vehicle insurance carrier.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• High school or equivalent (Preferred)

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Ability to Relocate:

• Lincoln, ME 04457: Relocate before starting work (Required)

Work Location: In person