Patient Referral Specialist

MSO - Women's Services; Austin (TX); Presencial; USD 40.000 - 52.000; Jornada completa

Descripción de la vacante

HCA Healthcare, Inc. is seeking a Patient Referral Specialist to coordinate physician, hospital, and outpatient referrals, schedule appointments, and obtain insurance authorization. The role requires precise data entry, strong communication, and adherence to privacy regulations.

Proficiency with EMR systems, insurance verification, and patient communication is essential to ensure timely care and maintain high-quality service standards within a busy healthcare environment.

Formación

• High school diploma or GED required.
• One year of experience in referral coordination involving insurance providers and authorizations.
• Knowledge of medical terminology and patient data handling.

Responsabilidades

• Schedule patient appointments and tests across providers.
• Determine insurance eligibility and obtain necessary authorizations.
• Enter demographics and referrals into EMR accurately.
• Communicate appointment details and preparation instructions to patients.
• Maintain referral records and ensure follow-up appointments.
• Weekly reporting on referral activity and status.

Conocimientos

Medical terminology

Interpersonal communication

Patient data handling

HIPAA compliance

Educación

High School Diploma or GED

Descripción del empleo

Do you want to join an organization that invests in you as a(an) Patient Referral Specialist? At MSO - Womens Services, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.

Job Summary and Qualifications

GENERAL SUMMARY OF DUTIES:

Processes physician, hospital, and outpatient referrals. Responsible for patient scheduling, obtaining insurance authorization, and providing appropriate guidance regarding insurance coverage. Essential duties and responsibilities are as follows. Other duties may be assigned.

PRACTICEREQUIREMENTS: Position eligible to be utilized in practices who see > 50 patients daily

DUTIES INCLUDE BUT NOT LIMITED TO:

• Works collaboratively with all diagnostic and surgical service areas, physician offices and hospitals to ensure timeliness, accuracy and completeness when scheduling patient appointments, tests and procedures.

• Consistently provides accurate and detailed patient information to include patient demographics and medical information pertinent to appointment being scheduled to ensure patient safety and quality patient care.

• Determine insurance eligibility and authorization for medical office and/or surgical visits; or works with authorization coordinator to ensure all payor authorizations have been received.

• Initiate EMR by entering demographics, referring and certifying physicians, and family information; obtaining needed medical records from referring providers.

• Establish rapport with all offices, hospital personnel, and managed care representatives.

• Utilize EMR or other designated programs to capture and track referrals.

• Obtains accurate and valid physician or advanced practitioner orders for all appointments, tests and procedures being scheduled.

• Accurately and consistently communicates appointment, test, procedure information and prep to patient and/or family member. Adheres to privacy, compliance and HIPPA regulations.

• Ensure patient has follow-up appointment with the physician to discuss outcomes, as appropriate.

• Consistently and accurately document the date and time of appointment, tests, scan or procedure in the patients medical record. Communicate as appropriate to practice staff and ensures the referral process is completed and closed.

• Outgoing referrals submitted same day, preferably with patient present to obtain the optimal appointment.

• Weekly reporting to practice leadership on referral volume, referral status, and follow up on outstanding appointments.

• Performs related work as required.

• Practice and adhere to the Code of Conduct and Mission and Value Statements.

EDUCATION:

High School Diploma or GED equivalent

EXPERIENCE:

One year of experience in referral coordination relating to insurance provider tier levels, insurance authorizations, and out of network procedures required

CERTIFICATION/LICENSE:

None required

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of medical terminology.

• Knowledge of common safety hazards and precautions to establish a safe work environment.

• Establishing and maintaining effective working relationships with patients, medical staff and the public.

• Must have good interpersonal skills.

• Ability to communicate effectively both verbally and in writing, and keep a positive