HIM/Referral Specialist

Position Summary Patient-focused, service-oriented, representative of the practice and health system. Maintains ongoing tracking through appropriate documentation on status of referrals and referral actions. Reviews referral information for completeness and accuracy. Assembles and provides complete clinical information according to provider preference. Routinely provides updates to patients and referring providers regarding referral status and activity. Reviews practice and appointment information with patients to establish understanding and set expectations for referral visit. Uses practice management software to accurately create new patient accounts; verify eligibility and benefits; and manage the flow of referral information. Ensures proper authorizations have been obtained for patient visits and services, and requests authorization for visits as necessary. Optimizes patient appointment scheduling by utilizing the provider template in concert with practice protocols. Routinely monitors appointment confirmations and cancellations to update schedules and fill appointment vacancies. Promptly answers assigned calls in a courteous and professional manner, assisting patients, answering general questions, providing practice information, and transferring callers or referring questions to the appropriate parties. Maintains a professional appearance and attitude, and an orderly, clean workspace to create a positive impression on patients and visitors. Protects patients’ privacy by maintaining confidentiality of medical, personal, and financial information. Coordinates patient interpretive services, accommodates patient disabilities, and readily assists patients with completion of forms. Performs medical language translation and/or transcription as required. Ensures clear and accurate communication between the healthcare provider and patients. Transcribes dictated medical reports to generate comprehensive and coherent patient documentation. Assists in numerous clerical tasks, and provides administrative support to the Practice Manager. Uses interpersonal skills to work effectively within the practice team, establish good working relationships with coworkers and referral sources, and provide a positive experience for patients and visitors. Education High School Diploma - Preferred Experience 4 Years Healthcare support - Required 18+ months experience working in a medical office or referral management setting - Required Meditech experience and accuracy and proficiency in computer applications a plus. License & Certification None Required Core Job Functions Actively manage incoming referral focused calls. Meets department standards for call times, call volumes, customer service and accuracy. Follows up on provider and patient concerns, and urgent referrals as warranted. Alerts patient of referral receipt, and schedules as appropriate once authorizations are obtained. Ensures accurate scheduling, rescheduling, cancellations, and verification of appointments with correct provider, modality, special equipment and studies. Repeats appointment date, time and location prior to ending call. Schedules & coordinates interpreters for patients as needed. Health service information is processed in a timely manner. Referrals, appointments, class/screening registration, web inquiries are processed and documented within the practice database accurately. Captures incoming external referrals in EMR. Assist sister departments in referral process and navigation. Handles incoming referral related requests via multiple mediums for sister departments. Documents physician practice referral interactions within the appropriate database according to the standards/practice for the physician practice. Provides patient and referring physician's office with updates regarding referrals and appointment until the process is completed. Documents and tracks patient correspondence hourly within the ARM/referral database. Adheres to PN referral status definitions. Sends written outreach per department operational procedures. Creates and populates new patient accounts in the medical records, procures external diagnostics and patient histories to best prepare the patient record for physician appointments. Transcribe internal test results into record per department process. Work incoming fax que and index, as assigned. Obtains insurance clearances for specialty referrals as warranted, prior to services being rendered. Accurately update auth information and record on referral status with notes in ARM or other designated referral software. Obtain visit authorizations per payor requirements. Assist in training referral personnel, general clerical duties, quality related projects, and cross coverage within the practice, etc.