Referral Specialist processes insurance pre-verification for hospital admissions or specialty service office visits. Gathers pertinent information from patients, insurance carriers, financial counselors, and other staff to confirm the patient's financial obligations for services. Being a Referral Specialist acts as a liaison between hospitals, clinical staff, health plans, providers, and patients to process referrals. Verifies insurance coverage and obtains required authorizations. Additionally, Referral Specialist resolves pre-certification, registration, and case-related issues. Documents referrals, communications, actions, and other data in an information system. Generates and distributes all applicable forms, notifications, and paperwork. May require an associate degree. Typically reports to a supervisor. The Referral Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Referral Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Lake Superior Community Health Center is currently seeking a .6 FTE Referral Coordinator for our Duluth location.
The Referral Coordinator works within the clinical care team to assure quality patient care and to support the goals of Lake Superior Community Health Center.
JOB QUALIFICATIONS AND CREDENTIALS
JOB KNOWLEDGE, SKILLS, AND ABILITIES
PRIMARY RESPONSIBILITIES
1. Creating, maintaining and completing referral documentation in the EHR.
2. Tracking referrals to promote team awareness and ensure patient safety.
3. Ensure complete and accurate registration, including patient demographic and current insurance information.
4. Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.
5. Ensure prior approval requirements are met.
6. Review details and expectations about the referral with patients.
7. Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g. request interpreters as appropriate, transportation services or prescription assistance).
8. Be the system navigator and point of contact for patients and families; be available for patients and families to directly ask questions and raise concerns.
9. Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
10. Ensure that referrals are addressed in a timely manner.
11. Remind patients of scheduled appointments via mail or phone.
12. Ensure that referrals are completed with appropriate visit documentation scanned into the EHR system.
13. Serve as a positive, enthusiastic, professional, and proactive member of the Health Care Home team.
14. Utilize patient- and family-centered care principles as a member of the Health Care Home team.
Job Type: Part-time
Pay: From $14.00 per hour
Weekly day range:
Education:
Work Location: In person
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