Patient Referral Specialist

1 week ago


Miami, Florida, United States OnePlus Healthcare Full time
Job Overview

Salary: Competitive

POSITION SUMMARY
The Patient Referral Specialist is responsible for overseeing and coordinating external specialty appointments requested by healthcare providers. This role is essential in ensuring seamless continuity of patient care in a timely and professional manner. The specialist fosters positive relationships for collaboration with local hospitals, ancillary departments, specialty physicians, and, most importantly, patients.

KEY RESPONSIBILITIES

  1. Oversee and manage all medical referrals.
  2. Engage directly with patients, establishing rapport and effectively exchanging information.
  3. Utilize the electronic health record (EHR) system according to departmental protocols, ensuring accurate data entry and retrieval for reporting purposes.
  4. Handle inquiries and requests, conducting necessary research and providing appropriate responses.
  5. Collect and enter data, documenting interactions thoroughly.
  6. Process insurance referrals and maintain comprehensive documentation for each authorization.
  7. Maintain ongoing communication with key insurance providers to ensure timely completion and follow-up of referrals and prior authorizations.
  8. Independently resolve issues or collaborate within a team environment.

ADDITIONAL DUTIES
Perform other responsibilities as assigned.

REQUIRED SKILLS AND COMPETENCIES

  1. Strong organizational abilities to manage multiple priorities while maintaining professionalism and composure.
  2. Capability to work effectively with a diverse range of individuals.
  3. Excellent telephone communication skills.
  4. High level of confidentiality due to the sensitive nature of information handled.
  5. Proactive in suggesting improvements to workflow or system efficiency.
  6. Ability to work independently, demonstrating self-direction and flexibility.
  7. Strong prioritization skills.
  8. Capacity to perform tasks with minimal supervision.
  9. Ability to maintain a high level of accuracy in a fast-paced environment.

QUALIFICATIONS

The following experience and skills are essential:

  1. A minimum of two years of experience in a medical office setting, with prior referral experience required.
  2. Ability to collaborate effectively with individuals from diverse backgrounds.
  3. Strong communication skills to interact professionally and courteously with all internal and external stakeholders.
  4. Excellent organizational skills.
  5. Ability to work both independently and as part of a team.
  6. Professionalism in managing multiple priorities.
  7. Articulate communication skills, both written and verbal.
  8. Accurate data collection, entry, and reporting capabilities.
  9. Willingness to learn and embrace new challenges and responsibilities.

EDUCATIONAL REQUIREMENTS

The following educational qualifications are necessary:

  1. High School Diploma or equivalent.
  2. Demonstrated understanding of the insurance referral process.
  3. Basic knowledge of medical terminology.


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