Referral Specialist

4 weeks ago

Providence, United States Brown Urology Full time
Job DescriptionJob Description

SUMMARY:

Coordination of Routine Referrals would be managed centrally to develop a dedicated, trained staff to manage referrals. This would better prepare patients for visit with specialist. Processing referrals would occur within 48 hours and health care cost reductions by directing patients in “In-Network” Providers. The position would help establish and maintain a preferred provider list, standardize patient centric workflow. Develops payer relationships to facilitate prior authorizations, standardize referral content and attachments. Position will help to reduce duplicate or unnecessary tests, prevent delayed diagnosis or treatment, minimize lost referrals and the access backlog.


PRINCIPLE DUTIES AND RESPONSIBILITIES:

Consistently applies the Brown Urology’s values of patient care priority, dignity, collaboration, integrity, and quality in support of our mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Responsible for knowing and acting in accordance with the Brown Urology’s Compliance Program and Code of Conduct.

Consistently practices the Brown Urology’s Customer Service Standards.


BASIC KNOWLEDGE:

  • Manage Referral beans in eClinical Works for assigned Providers/Resources
  • Ensure Referral Request form is completed
  • Ensure Referral is received and reviewed
    1. Is produced under the BUI TIN/Provider and correct location
    2. Declined or redirected (not needed, wrong specialty, lack of availability)
    3. Patient defers making appointment, declines or cannot be reached (if Specialty is making the appointment)
  • Track referral response
  • Add referral/authorizations into eClinical Works system
  • Inactivate expired referrals/authorizations in the eClinical Works system
  • Document secondary referrals if indicated
  • Close referral when completed
  • Assist Call Center and/or Medical Secretary staff as needed; Work collaboratively with secretarial staff to reschedule non-urgent appointments without a referral in place


EXPERIENCE:

  • Minimum 3-5 years’ experience in a medical office setting
  • eClinical Works experience preferred
  • 1-3 years’ experience with referrals


WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

Conditions common to a clinical practice environment including potential exposure to communicable diseases, medicinal preparations, and hazardous materials. Involves frequent contact with patients. Work may be stressful at times.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position will require standing and walking for majority of workday.

INDEPENDENT ACTION:

Incumbent functions independently within the guidelines established by the policies and procedures of organization.

SUPERVISORY RESPONSIBILITY:

None.


EOE/F/M/Vet/Disabled

Brown Urology requires employees to be vaccinated against COVID as a condition of employment, subject to accommodation for medical exemptions.



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