What are the responsibilities and job description for the Referrals Specialist position at SouthernMED Pedatrics?
Description :
Obtains information, insurance verification and authorization required for proper patient treatment and referrals. Performs a variety of duties in accordance with federal, state and local regulations along with established priorities and procedures of the practice.
Job Tasks :
Reviews orders written by providers and determines where test and procedures may be performed based on patient's insurance.
Pre-authorizes, pre-certifies the test or procedure if required.
Coordinates scheduling with the patient and the outside entity.
Schedules patients who are referred to specialty practices by our providers.
Attend staff meetings as required.
Organizes, plans, and manages time effectively.
Meets position requirements and performs essential functions.
Completes all mandatory training as required.
Performs other duties as assigned.
Quality and Customer Satisfaction :
Demonstrates commitment to superior customer experiences with a service-oriented attitude.
Collaborates with others to coordinate care, resolve concerns, and address the needs of patients, family members, physicians and employees.
Considers patient and employee safety. Takes initiative to identify and eliminate risks.
Respects and considers patient rights to privacy and complies with all HIPAA guidelines for maintaining confidentiality.
Interpersonal Skills :
Communicates professionally and appropriately at all times.
Builds strong working relationships with co-workers and other staff while recognizing individual talents and perspectives.
Identifies, analyzes and solves problems.
Accountability and Productivity :
Accepts responsibility for decisions and actions.
Utilizes appropriate resources to effectively and successfully execute responsibilities.
Adheres to regulatory and company policies and procedures.
Requirements
QUALIFICATIONS
- High school diploma or equivalent.
- Prior medical practice experience preferred.
- Knowledge and prior experience with insurance verification preferred.
- Basic knowledge of medical terminology.
- Working knowledge of computer applications. Prior experience with EMR preferred.
- Ability to speak, read and write effectively.
- Demonstrate proper telephone etiquette
- Ability to work independently without direct supervision.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines, in a detail-oriented manner.
WORKING CONDITIONS
Physical requirements
DIRECT REPORTS - None
