What are the responsibilities and job description for the Referral Specialist position at TCA Health Inc.?
POSITION SUMMARY
The Referral Specialist is responsible for coordinating, processing, and tracking referrals for our patients, while communicating with facility providers, patients, external health care organizations, and insurance companies.
ESSENTIAL DUTIES AND RESPONSIBILITIES (Include but not limited to the following);:
- Refers patients to external doctors/specialists, and on occasion will assist in scheduling appointments when patient is in need of assistance.
- Maintains ongoing tracking and appropriate documentation on referrals to promote care team awareness and ensure patient safety.
- Assembles information concerning patient’s clinical background and referral needs. Per referral guidelines, provides appropriate clinical information to specialist.
- Contacts insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis, and prognosis.
- Notifies patients by telephone of appointment and sends a follow-up reminder letter for scheduled appointments.
- Review referral expectations and needs with patients.
- Establish and maintain relationships with service providers.
- Requests consultation notes from specialists when requested by TCA Health Providers.
- Copies charts and faxes notes to external specialists when requested.
- Ensure that a patient’s primary care record is up to date with information on specialist consults, hospitalizations, E.R. visits, phone communications and community resources related to their health.
- Participates in the collection of quality data as needed, such as number of referrals by day/month.
- Under the direction of the Director of Clinical Services, all other duties as assigned.
REQUIRED SKILLS AND ABILITIES
(To perform this job successfully, an individual must have the following skills)
- Must be able to work independently.
- Must be willing to adapt to change and maintain a professional demeanor at all times.
- Must be able to handle a fast-paced diverse workplace in a team environment.
- Ability to think clearly and analyze problems.
- Ability to handle sensitive and confidential assignments with tact and diplomacy.
- Must be able to work under pressure and time constraints, handle changing priorities, establish, and maintain cooperative working relationships.
- Must be able to communicate effectively (verbally, telephonically, and written).
QUALIFICATIONS
- High School Diploma or equivalent
- Knowledge of I-Care and Athena EMR systems.
- Proficiency in Microsoft Office for data entry tracking and reporting.
COMPETENCIES
(To perform the job successfully, an individual should demonstrate the following competencies)
Design - Demonstrates attention to detail.
Problem Solving - Identifies and resolves problems in a timely manner; Develops alternative solutions; Works well in group problem solving situations.
Customer Service - Responds to requests for service and assistance; Meets commitments.
Interpersonal Skills - Maintains confidentiality; Keeps emotions under control.
Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Participates in meetings.
Written Communication - Writes clearly and informatively; Able to read and interpret written information.
Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; supports organization's goals and values.
Judgment - Exhibits sound and accurate judgment; Makes timely decisions.
Planning/Organizing - Prioritizes and plans work activities.
Professionalism - Reacts well under pressure; Follows through on commitments.
Quality - Demonstrates accuracy and thoroughness.
Dependability - Follows instructions, responds to management direction; Keeps commitments.
EDUCATION AND EXPERIENCE
- A minimum of 6 months of relevant work experience in a medical practice.
- Must have knowledge of basic medical terminology.