What are the responsibilities and job description for the Medical Referrals Specialist position at North Florida Surgeons Orthopaedic Associates, LLC?
- Referral specialists are responsible for ensuring patients are already cleared for specialty service office visits. They resolve registration, pre-certification, and case-related affairs before the client's appointment. Also, they give support to clinical staff to manage the administrative components of clinical referrals for many services. They must gather relevant information from financial counselors, insurance carriers, and other supplementary staff to make sure the patient's financial responsibility for services are provided. Additionally, they act as a liaison between the patients, physicians, hospitals, health insurance vendors, or other referral sources.
- Research referrals and either deny or approve based on information obtain and appropriately identify diagnosis (CPT and ICD-9 coding).
- Maintain confidentiality by following all applicable HIPAA regulations.
- Maintain accurate EMR documentation of all service given to patient under strict confidentiality.
- Coordinate patient data collection with various schedules-appointments for patients upon receipt/confirmation of authorization from referral source.