Referral Specialist

3 months ago

Olympia Fields, United States AUNT MARTHAS HEALTH AND WELLNESS INC Full time
Job DescriptionJob Description

Aunt Martha’s Health and Wellness boldly commits to supporting the well-being of our communities, ensuring equity in access and delivering exceptional care inspired by a culture of innovation. We are taking a responsible approach to creating environments that allow us to do what we do best—provide healthcare and wellness. As a part of our commitment to health and safety, COVID-19 vaccines are required for all employees, as well as all newly hired employees. We require documentation upon hire.


SUMMARY

Under the direct supervision of the Referral Department Nurse Manager, the Referral Specialist performs general functions including reviewing and processing of all medical orders. Referral Specialist also ensure the order is covered by patient’s health plan, as well as within organization standards. In addition, the Referral Specialist provides patients with updates on submitted orders. The Referral Specialist provides excellent quality care, positive customer service, the maintenance of an efficient and safe environment of care. Demonstrates superior customer service skills and has the ability to function in a multi-tasking, multiple priorities environment, while maintaining accuracy and attention to detail.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Maintain patient confidentiality at all times per the policies and procedures.
  • Maintain ethical behavior at all time per the policies and procedures.
  • Responds to internal and external customer needs in a positive manner, utilizing principles of the AIDET model; exceeding their needs and expectations and providing the highest quality service to ensure the best possible outcomes.
  • Master the electronic health record system, Athena, to appropriately document patient data and information.
  • Answers designated telephone calls in a courteous manner, appropriately routes communication, responds to inquiries and transcribes messages.
  • Tracks, monitors, and verifies insurance eligibility in a timely manner for all medical orders as well as ensuring order meets meeting organizational standards.
  • Complete prior authorizations, if needed for orders.
  • Functions as contact between Aunt Martha’s Health and Wellness to provide patient with status of orders.
  • Acts as a liaison between patient and referring agency to ensure patient is provided with prompt and effective patient care.
  • Collaborate with health plans, specialists, hospitals, and physicians to ensure completed referrals.
  • Communicate with patients by phone and/or mail regarding the status of order submitted by clinic (referral, diagnostic order, surgery request and transportation.)
  • Scan and file in patient’s HER file all results/communication received from specialist or hospitals.
  • Attend all trainings and meetings as required by the program.
  • Complete all Core Curriculum training(s) required for this position.
  • Perform all other duties as assigned.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.


EDUCATION and/or EXPERIENCE

  • High school diploma or general education diploma (GED) required and over six months’ experience in a medical office
  • Experience in working with Microsoft Office programs essential.; adept at data entry.

OTHER QUALIFICATIONS

  • Current driver’s license
  • Current auto insurance
  • Ability to work late evening hours, weekend hours, and scheduled holidays, as needed.


Aunt Martha’s is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

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