Referral Specialist

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Key / Essential Functions & Responsibilities

• Provides clerical and administrative support for patients and their circles of support serving as the primary resource for arranging and scheduling referral appointments for external specialists, diagnostic or surgical procedures, providing excellent service to patients, circles of support, external entities and clinic staff while ensuring appropriate tracking, follow-up and coordination for referral-related matters or inquiries.
• Prioritizes work to ensure that urgent referrals are handled expeditiously and preventative care / wellness visits or procedures are handled and scheduled in a timely manner on a first come, first served basis.
• Meets with patients after receiving and reviewing referral requests from providers to assist with scheduling of appointments or to provide resources, such as copies of referrals or local providers and facilities that can complete necessary procedures or coordinates scheduling with other PHC providers for in-house referrals.
• Obtains necessary pre-authorization approvals, which may include liaising with providers to secure primary care physician approval or letters of medical necessity and refers patients to authorized providers as required by the insurance company, when applicable.
• Establishes rapport with patients and circles of support by facilitating open conversation during the referral process and keeps patients abreast of any updates or requests for additional information by the external healthcare professionals and / or insurance company involved in the referral process.
• Refers patients to participating or authorized providers within the appropriate network to maintain maximum financial incentives / reimbursement from payors as directed by provider.
• Ensures that proper documentation is forwarded to external providers performing procedures as required and appropriately updates patient's medical records with copies and notes, as applicable.
• Maintains contact with referral patients to ensure that services are received as scheduled and monitors to ensure results are received, reviewed and signed by referring provider; follows-up with external providers to obtain results or reports when not received timely or make requests to expedite results.
• Ensures that all documentation and results are appropriately scanned, saved, uploaded and / or otherwise added to patient's electronic medical record, in accordance with all applicable policies and procedures and closes out completed referrals on a timely basis.
• Provides education, information and / or updates regarding referrals or referral process to other clinic support staff and to clinical staff, providers or leadership; may assist providers in identifying appropriate network / healthcare providers for referrals based on patient details.
• Identifies and establishes connections with participating external providers and practices in local area (e.g. borough) and maintains relationships to support efficient communications, reduce turn-around time and support patient care and experience.
• Maintains insurance referral information for the practice ensuring that it is current, organized and accessible to providers and staff.
• Complies with all Federal, State, Local and other relevant regulatory agency requirements, including the Health Insurance Portability and Accountability Act (HIPAA).
• Performs all duties of a Medical Receptionist to support day-to-day operations of the clinic, as needed or requested.
• Performs all other duties, as assigned.

Minimum Qualification Requirements including education, experience, licensure / certification, etc. and essential physical capabilities (e.g. lifting, assisting lifting, standing, etc.)

Preferred Qualification Requirements (desired requirements beyond MQRs above)

Pay Rate : $17.29

Schedule : 9am-5pm 3 days a week

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.

Salary : $17