Referral Specialist I

Description

Job Title: Referral Specialist I

Position Code: C18N Non-Exempt

Department: Administration

Position Category (330): Eligibility Assistance Workers (L27a)

Position Category (Rphca): Other Staff

The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

A. POSITION SUMMARY

Under the supervision of the Health Center Manager, the Referral Specialist I is part of a team that includes other support staff members and healthcare providers. The Referral Specialist I is primarily responsible for tracking the status of provider-directed referrals, to include closing out referral tasks by obtaining and properly documenting reports resulting from referral. A Referral Specialist I may also intermittently perform additional tasks, to include scheduling appointments, verifying insurance

information and otherwise assisting to ensure that provider-generated referrals for FCCH patients are performed efficiently and effectively.

B. ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Maintains ongoing tracking of and appropriate documentation regarding the status of provider- directed patient referrals, to include system sufficient to report data and status to others;
2. Helps ensure complete and accurate patient registration information, to include demographic data and current health insurance information;
3. Communicates with patients, providers and other staff regarding the status of referrals;
4. May contact insurance companies to confirm that prior approval requirement are met and/or to provide needed patient information(e.g., health history, diagnosis, prognosis, provider visit documentation);
5. May schedule patient referral appointment, to include provision and dispensation of necessary paperwork and related patient instructions;
6. Attends and contributes to meeting as needed or required;
7. Performs miscellaneous job-related duties as assigned

Requirements

C. MINIMUM EDUCATION AND EXPERIENCE

1. High school diploma or GED and at least one year of medical office or other related healthcare experience.
2. Bi-lingual Spanish-speaking skills highly preferred, experience in a multiple provider setting and experience with electronic health records and healthcare practice management systems preferred.

D. LICENSES/CERTIFICATIONS REQUIRED

Medical assisting skills/certification/experience is highly preferred. CPR certification required within 6 months of hire.

E. KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED

1. English proficiency, to include reading, writing and verbal communication;
2. Demonstrable working proficiency using Microsoft Office applications, including Word, Excel and Outlook;
3. Excellent organizational and time management skills;
4. Demonstrated knowledge of medical terminology/standard medical acronyms; working knowledge of ICD-10/CPT coding;
5. Ability to interact and communicate with others in a professional manner, in person and over the telephone and often in stressful situations;
6. Ability to apply excellent customer service skills;
7. Efficient, effective work ethic required in order to accomplish assigned tasks in a fast-paced office environment;
8. Ability to work well as a collaborative member of a team;
9. Demonstrated knowledge of patient care charts and patient medical histories;
10. Ability to maintain calendars and schedule appointments;
11. Appropriate knowledge of related accreditation and certification requirements;
12. Records maintenance skills;
13. Maintains knowledge of patient registration procedures and documentation;
14. Ability to analyze and solve problems;
15. Appropriate knowledge and familiarity with various compliance programs and elements. Cooperates fully and complies with applicable laws and regulations;
16. Knowledge and familiarity with compliance program. Cooperate fully and comply with laws and regulations;

F. AGE OF PATIENTS SERVED

All ages

G. PHYSICAL CHARACTERISTICS/WORKING CONDITIONS

A person in this position has sufficient time to complete most tasks required to meet deadlines and goals based on patient and organization demands. There are frequent opportunities to relax from any physical exertion or to change position in work activities.

1. Physical Effort and Dexterity: Good dexterity to operate personal computer equipment. Light physical activity expected, to include minimal handling of low-weight objects up to 10 pounds.
2. Machines, Tools, Equipment required to be operated: Capable of using office machines and personal computers for word processing, data entry and retrieval.
3. Visual Acuity, Hearing, and Speaking: Must be able to read computer monitor output accurately. Must be able to communicate clearly and accurately for work and safety compliance.
4. Environment/Working Conditions: Work is mostly performed inside a clinic in a controlled environment. Normal clinic safety precautions and practices are required. Position may require travel throughout the FCCH operations area. Work regularly scheduled hours Monday-Friday, although evenings/weekends may be required to meet deadlines or to support necessary changes in health center needs. First Choice Community Healthcare provides all training required by OSHA to ensure employee safety.