Referral Specialist - Medicine

Position Summary
Handles all aspects of patient referrals, from processing the doctor's order referral, to scheduling the patient and preparing an insurance referral. Provides effective and efficient customer service to patients and interacts with other MFA departments professionally.
Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
Generates both internal and external referrals for patients as required.
Utilizes insurance payer websites to process insurance referrals as needed for patients.
Understands insurance policies for referral creation, including but not limited to requirements and duration/expiration guidelines.
Maintains referral order worklist- process requests and reach out to patients for scheduling.
Accurate creation and direction of tasks, including assessing urgency, to the appropriate individual, to include admins, teams, providers, etc.
Proficiency in all aspects of scheduling, including making, canceling, and rescheduling appointments based on appointment guidelines by department.
Provides patient instructions verbally or in writing when necessary for patient to prepare for appointment.
Works with administrative assistants and other internal departments to efficiently and effectively resolve customer needs.
Ensures quality and safe delivery of health care services through accurate documentation.
Displays in depth knowledge of both General Internal Medicine as well as Medicine Specialty Divisions.
Assist with completing administrative tasks generated by the providers under the supervision of management and floor supervisors.
Ability to perform at satisfactory levels in listening skills, communication, and problem analysis.
Works collaboratively with members and staff across service lines.
Follows all HIPAA guidelines and complies with annual training.
Demonstrates an awareness and sensitivity towards patient/family rights.
Complies with departmental standards regarding training, professional development, communication, management of workload, and safety/emergency situations.
Prepares and mails appointment notices and patient information, as required.
Ability to perform job duties at satisfactory levels using computer based scheduling programs, including AllScripts/GE.
Assist Contact Center Management with other daily and weekly tasks as assigned.
Other duties as assigned.
RequirementsRequired Skills and Competencies
Excellent verbal and written communication skills, including but not limited to use of proper grammar and phone etiquette.
Excellent customer service skills.
Strong interpersonal skills; must be able to work with a team and receive constructive feedback.
Excellent active listening skills and problem solving ability.
Must be able to maintain composure and professionalism at all times.
Proficiency in Microsoft Office, including Outlook, Word, and Excel.
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.
Education Associates degree preferred, high school graduate or equivalent required. Knowledge of medical terminology or completion of medical terminology coursework desired.
Experience Internal Candidates: Minimum of six months' work experience in a medical/healthcare environment, such as a hospital, physician office, ambulatory clinic, or healthcare call/contact center specifically handling referrals. Prefer some experience with insurance referrals. Experience utilizing a web-based computerized system for scheduling and Microsoft Office programs, Word and Excel, is required. Typing speed at a minimum of 45 WPM is required.
External Candidates: Experience in healthcare is required; specific experience handling referrals is desired. 2-5 years' work experience required; in a doctor's office setting or hospital environment is preferred. Experience utilizing a web-based computerized system for scheduling and Microsoft Office programs, Outlook, Word and Excel, is required. Typing speed at a minimum of 45 WPM is required.
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