Referral Specialist

4 weeks ago

Rome, United States Rome Memorial Hospital Full time
Job DescriptionJob Description

The Referral Specialist schedules appointments for patients for testing and/or to see specialists as ordered by the patient's provider of care. The Referral Specialist will:


•Adhere to Rome Health's Compliance Plan, Policies and Procedures, HIPAA Privacy and Security, Safety and PCMH Health Policies to maintain a quality level of service for patients and protect the confidentiality of patients Protected Health Information (PHI).
•Answer phone calls and assist patients with questions as needed.
•Maintain ongoing tracking and appropriate documentation of referrals.
•Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.
•Contacts insurance carriers to obtain and ensure prior approval requirements and/or authorizations are met. Present necessary medical information such as history, diagnosis and prognosis.
•Records time and date of appointment and method of patient notification in EMR.
•In coordination with guidelines for PCMH, review details and expectations about the referral with the patient, explaining any special instructions regarding test ordered and provides written instructions as applicable.
•Ensures that referrals are addressed in a timely manner.
•Contact patients with scheduled appointments via mail or phone.
•Maintains good communication skills with providers, supervisors, coworkers, patients and other departments, as applicable.
•Performs other related duties as necessary to maintain efficient workflow.
•Answering phones and other receptionist duties included.


SKILLS AND QUALIFICATIONS:


•High School diploma
•Knowledge of referral process and insurance industry.
•Organized, meticulous, with great attention to detail and able to manage priorities.
•Effective verbal and written communication skills.



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