POSITION TITLE: Referral Specialist
POSITION SUMMARY:
Under the supervision of the office supervisor and/or Director, the Referral Specialist is responsible for processing referral orders by obtaining necessary prior authorizations and ensuring safe, successful transitions of care for patients.
Duties include written and verbal communication with insurance agencies, medical entities, providers, patients, and peers; maintaining accurate and complete patient records with clear and comprehensive documentation; and utilization of extensive knowledge of payor plans, diseases processes, radiology tests, and healthcare providers both locally and in surrounding communities.
Ability to work remotely if desired.
ESSENTIAL JOB FUNCTIONS:
Is consistently at work and on time, as established.
Prioritizes referrals by urgency and addresses them in a timely manner.
Uses time efficiently.
Ensures complete demographic, insurance information and appropriate/pertaining clinical information is sent to referred servicing providers.
Contacts insurance companies to ensure prior authorization requirements are met.
Presents necessary medical information to insurance companies to prove medical necessity of request.
Researches and locates out-of-area specialists as needed for referrals.
Able to work additional hours when necessary to reach goals.
Communications - Speaks clearly and professionally in positive or negative situations; listens and gets clarification; responds well to questions and feedback; participates in meetings; edits work for spelling and grammar; keeps others adequately informed; selects and uses appropriate communication methods.
Keeps abreast of current developments; requires minimal supervision; displays understanding of how job relates to others; maintains confidentiality per policy and regulations.
Fluent in Word, Excel, and Outlook as well as job-related software and computers; uses available resources effectively; adapts to new technologies; keeps technical skills up to date.
Demonstrates competence in relation to the defined mission, vision, values, and strategic plan of the organization.
Apparent by ongoing completion of any or all of the following: proficiency testing, skill demonstration, practice of core standards for service excellence, and documentation review.
MARGINAL JOB FUNCTIONS:
Performs other duties as assigned.
Minimum Requirements
QUALIFICATIONS:
REQUIRED:
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
TYPICAL PHYSICAL/MENTAL DEMANDS:
While performing the duties of this job, the employee is required to sit or stand, walk, and reach.
The employee must occasionally lift and/or move up to 10 pounds.
Specific vision abilities required by this job include close vision, ability to adjust focus, and view a computer monitor throughout the shift.
The employee must be clear thinking and able to focus on work tasks amidst open office distractions and competing priorities.
PAY RANGE: $18.
15 - $26.
75
Whatsapp
