Referral Coordination Specialist

2 weeks ago

Providence, Rhode Island, United States Brown Urology Full time
Job Overview

SUMMARY:

The central management of routine referrals aims to cultivate a dedicated and trained team to oversee the referral process. This initiative is designed to better prepare patients for their consultations with specialists. Referrals will be processed within a 48-hour timeframe, contributing to healthcare cost savings by directing patients to 'In-Network' providers. This role will assist in establishing and maintaining a preferred provider directory and standardizing patient-centric workflows. The position will also focus on developing relationships with payers to streamline prior authorizations and standardize referral documentation and attachments. Ultimately, this role is instrumental in minimizing duplicate or unnecessary tests, preventing delays in diagnosis or treatment, and reducing the backlog of referrals.

KEY RESPONSIBILITIES:

Uphold the values of patient care priority, dignity, collaboration, integrity, and quality in alignment with our mission to deliver compassionate, high-quality patient care, research excellence, and outstanding physician education. Adhere to the Compliance Program and Code of Conduct.

Consistently implement the Customer Service Standards.

ESSENTIAL SKILLS:

  • Manage referral requests in eClinical Works for designated providers/resources.
  • Ensure completion of the Referral Request form.
  • Verify receipt and review of referrals.
    1. Confirm production under the correct BUI TIN/Provider and location.
    2. Handle declined or redirected referrals (not needed, incorrect specialty, lack of availability).
    3. Document instances where patients defer making appointments or cannot be reached (if the specialty is responsible for scheduling).
  • Monitor referral responses.
  • Input referrals/authorizations into the eClinical Works system.
  • Inactivate expired referrals/authorizations in the eClinical Works system.
  • Document secondary referrals as necessary.
  • Close referrals upon completion.
  • Support Call Center and/or Medical Secretary staff as needed; collaborate with secretarial staff to reschedule non-urgent appointments without a referral.

EXPERIENCE REQUIRED:

  • 3-5 years of experience in a medical office environment.
  • Experience with eClinical Works is preferred.
  • 1-3 years of experience managing referrals.

WORKING CONDITIONS:

Typical conditions found in a clinical practice environment, including potential exposure to communicable diseases, medicinal preparations, and hazardous materials. Frequent patient interaction is expected, and the role may involve stressful situations.

PHYSICAL REQUIREMENTS:

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

INDEPENDENT FUNCTIONING:

The incumbent operates independently within the guidelines established by the organization's policies and procedures.

SUPERVISORY RESPONSIBILITY:

This position does not have supervisory responsibilities.

EOE/F/M/Vet/Disabled

Brown Urology mandates that employees be vaccinated against COVID as a condition of employment, with accommodations available for medical exemptions.

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