SUMMARY:
Under the supervision of the Referral Specialist Manager, the Referral Specialist supports the medical providers at the clinic by coordinating any additional care the patient may need inside and outside of our facilities. This position is responsible for completing referrals of patients to specialists to ensure follow-up care is provided and is responsible for obtaining prior authorizations needed for testing or services. The Referral Specialist supports patient-centered care by ensuring coordination with the primary care provider, specialist(s) and the patient to ensure optimal patient outcomes. ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Expedites referrals entered into electronic health records system (EHR) by providers according to SBNC Policies and Procedures and in a timely manner.
• Assembles information concerning patient’s clinical background and referral needs to provide to the specialist offices.
• Strives to expedite referrals for patients at the date of service.
• Schedules referral appointments and informs patients of appointment details such as location, date and time, etc.
• Tracks all referrals for completion, receipt of specialists’ records in EHR with the support of the medical assistant staff.
• Assists with scanning of paper consultation, imaging, etc. reports and uploads into EHR.
• Protects patients’ confidentiality and right to privacy.
• Provides appropriate referral authorizations to specialist offices.
• Obtains prior authorizations for diagnostic services and procedures.
• Provides back up support to other positions in the organization such as the Patient Access Navigator and Medical Assistant.
• Verifies patient eligibility, address, and phone number with each visit.
• Keeps work area clean and orderly.
• Checks email upon arrival every morning and throughout the day to keep himself/herself informed of day to day functions and important communications with administration and clinic staff.
• May need to cover at other sites if needed.
OTHER DUTIES AND RESPONSIBILITIES:
1. Demonstrates understanding of and observe all SBNC policies, procedures, rules and regulations.
2. Demonstrates successful work-related behaviors.
3. Attends all required SBNC meetings and trainings.
4. Interacts with patients, physicians, staff, vendors, and visitors in a positive manner that reflects the SBNC mission and philosophy.
QUALIFICATIONS AND EDUCATION REQUIREMENTS:
Experience: Prior experience in a medical care setting or equivalent combination of education and experience.
Knowledge of: Medical terminology; use of standard software such as Windows, Word and Excel.
Ability to: Speak fluent Spanish as well as English; follow verbal and written instructions; communicate effectively; interact diplomatically with staff, patients, and other healthcare providers; follow up on outstanding items; use basic office equipment including computer, copy machine, fax machine, and postage meter.
Preferred Qualifications: Minimum keyboard speed of 60 WPM.
Physical Demands: May be required to lift objects weighing up to 20 pounds. Sitting in a normal seated position for extended periods of time. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard. Communication skills using the spoken word. Ability to see within normal parameters. Ability to hear within normal range. Ability to move about.
