Referral Specialist jobs in Raleigh, NC

1. Good Judgment
2. Communication/Customer Service/Teamwork
3. Passion
4. Honesty
5. Responsibility
6. Job-Specific Skill Set

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

• Responsible for scheduling STAT/URGENT referrals, tracking referrals and tracking hig risk referrals and actions
• Responsible  for obtaining prior authorization from Insurance carriers for ordered Diagnostic Testing/ Procedures and ordered Specialty Referrals.
• Maintains confidentiality of patient health records and other information as required by applicable laws
• Processes referrals in a timely fashion, including sorting and processing referrals by indicated urgency and date
• Refers patients to specialists based on available medical, financial, and transportation resources
• Documents and enters all referrals appropriately in patients’ health record
• Reviews with patients the referral details including their own responsibilities
• Verifies that providers have sufficiently documented the reason for the referral and have done the appropriate workups prior to the referral
• Assembles and forwards complete and accurate documentation
• Maintains ongoing tracking of all referrals
• Handles incoming phone calls and responds to requests for information from patients and outside sources
• Performs other duties as assigned
• Actively participates in quality improvement teams/meetings
• Monitors and tracks high risk and current cancers.

• High school diploma or GED.
• Outpatient physician office experience strongly preferred
• Ability to multi-task and work efficiently in a potentially stressful environment
• Ability to apply common sense understanding when carrying out detailed written or oral instructions
• Ability to establish and maintain positive, effective, professional relationships with patients, providers, coworkers, and superiors
• Possess knowledge of modern office equipment, Microsoft Office software programs, medical practice management systems, and basic computer skills (including the ability to type)
• Must be able to quickly learn to use eClinicalWorks electronic health record system
• Must have excellent organizational, telephone, and verbal and written communication skills
• Physical Demands: Must be able to sit for long periods of time.  Must be able to lift 25-50 pounds.  Must be able to ambulate for extended periods of time.
• Embraces the team concept; encourages and models healthy, productive team behavior
• Bilingual (English/Spanish) is a plus, but not required - applicants who may serve in a translating capacity will be required to take a language assessment