Patient Referral Specialist

HCA Healthcare, Inc.; Dallas (TX); Remote; USD 25,000 - 33,000; Full time

Benefits offered by this job

Work from Home

Total rewards package

Tuition assistance

401(k) Plan with match

Life insurance

Job summary

HCA Healthcare is seeking a Patient Referral Specialist to process physician, hospital and outpatient referrals, schedule patients, and obtain insurance authorization.

You will collaborate with diagnostic services, physician offices, and hospitals to ensure timely appointments, verify eligibility, capture demographics in the EMR, and communicate prep instructions to patients and families. This is a full-time, weekday role with work-from-home options and a comprehensive benefits package.

Qualifications

• High School Diploma or GED equivalent.
• 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.

Responsibilities

• Processes physician, hospital, and outpatient referrals and schedules patients.
• Obtain insurance authorization and verify eligibility for visits and procedures.
• Enter demographics and referral information into EMR; coordinate with referring providers.
• Communicate appointment details and prep instructions to patients and families.
• Collaborate with offices, hospitals, and managed care representatives to ensure timely scheduling.
• Maintain accurate records of appointments, tests, and procedures in the medical record.
• Provide weekly reports on referral volume and status to practice leadership.

Skills

Patient scheduling

Insurance authorization

EMR systems

HIPAA compliance

Communication

Interdepartmental collaboration

Education

High School Diploma or GED

Tools

EMR software

Insurance verification tools

Job description

Seeking a Patient Referral Specialist for our practice who 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.

Job Summary and Qualifications

Full time (Monday - Friday, days), no nights, no on-call, no weekends, no holidays

What will you do in this role:

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.

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 appointments being scheduled to ensure patient safety and quality patient care.

Determine insurance eligibility and authorization for medical office and/or surgical visits; or work 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 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 the patient has a 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 patient's medical record. Communicate as appropriate to practice staff and ensure the referral process is completed and closed.

Outgoing referrals submitted the same day, preferably with patients 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.

What Qualifications you will need:

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

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services

• Wellbeing support, including free counseling and referral services

• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence

• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling

• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing

• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

Physician Services Group (https://careers.hcahealthcare.com/pages/physician-services) is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times.

In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.