Referrals Specialist

Description

Neighborhood Outreach Access to Health (NOAH) is a non-profit Federally Qualified Health Center (FQHC) that provides comprehensive, integrated, and affordable high-quality healthcare services to underserved populations. We provide comprehensive care to over 40,000 neighbors including medical, dental, behavioral health, psychiatric, nutrition, pharmacy services, preventive health, eligibility assistance, and health education programs. NOAH embraces all people, and we respect everyone for who they are. We firmly believe that diversity is our strength and stand firmly committed to the principles of Justice, Equity, Diversity, and Inclusion.

Job Summary: 

The Referrals Specialist coordinates specialty referrals incoming and outgoing, eligibility verification, and maintenance for practice patients.

Duties/Responsibilities:

• Obtains patient information and referral request documentation, maintains patient files, verifies information, and reports statistics and data.

• Compiles pertinent medical data and supporting documentation and sends to appropriate recipients.

• Verifies eligibility, benefits, and contractual appropriateness.

• Acts as liaison between practice, patients, referral sources, and health insurance companies to resolve complaints and problems.

• Serves as expert internal consultant to all levels of practice staff.

• Monitors and resolves the status of problem authorizations.

• Compiles patient information in accordance with their insurance plan’s referral requirements.

• Ensures prior approval requirements are met by contacting review organizations and insurance companies.

• Ensures that patient's primary care chart is up to date with information on specialist consults related to their health.

• Assists with training and orientation of new Referral Coordinator’s into practice.

• Trains new Referral Coordinator employees on correct policies and procedures as needed.

• Obtains information from multiple sources and completes data entry duties to update patient information in EMR system.

• Communicates with patients through EMR system, mail, or phone to confirm patient information, review details and expectations of referrals, and send reminders of upcoming appointments.

• Adheres to organizational policies, safety standards, and healthcare regulations, including HIPAA and other compliance requirements.

• Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.

• Performs other related duties as assigned.

Qualifications

Required Skills/Knowledge/Abilities:

• Excellent verbal and written communication skills and ability to interact with individuals of various social, cultural, and educational backgrounds.

• Good organizational skills and administrative abilities.

• Knowledge of medical terminology.

• Excellent problem-solving and critical thinking skills.

• Detail-oriented and professional.

• Ability to exercise confidentiality, discretion, and good judgment.

• Proficient with Microsoft Office Suite and EMR software.

Education and Experience:

Required:

• High school diploma or GED required.

• 1 years of Referral or related work experience required.

Other Requirements:

• New Hires are required to pass pre-employment background check and drug testing (effective 11/1/2022).