Patient Referral Specialist

HCA Healthcare; Houston (TX); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Healthcare benefits

Wellbeing support

Paid time off

Retirement plan

Education support

Fertility benefits

Job summary

HCA Healthcare’s MSO - Houston Colorectal Surge is seeking a Patient Referral Specialist to coordinate referrals across physician, hospital and outpatient settings. This full-time role emphasizes accurate scheduling, insurance authorizations, and guiding patients on coverage, with no nights, weekends, or holidays.

You will enter demographics in the EMR, obtain needed medical records, verify insurance eligibility, and ensure referrals are tracked and closed while maintaining HIPAA compliance and

Qualifications

• High School Diploma or GED equivalent.
• One year of referral coordination experience with insurance authorizations.
• Proficiency with EMR systems and patient data entry.

Responsibilities

• Coordinate referrals with diagnostic and surgical teams to ensure timely scheduling.
• Provide accurate patient demographics and medical information for appointments.
• Determine insurance eligibility and obtain necessary authorizations.
• Enter patient demographics, referrals, and physician orders in EMR.
• Maintain rapport with offices, hospitals, and managed care representatives.
• Track referrals and ensure completion and closure.
• Document appointment details in medical records and communicate prep instructions.
• Submit outgoing referrals on the same day when possible.
• Report weekly on referral volume and status.

Skills

Scheduling

Insurance authorization

EMR input

HIPAA compliance

Patient communication

Education

High School Diploma or GED

Job description

Do you want to join an organization that invests in you as a(an) Patient Referral Specialist? At MSO - Houston Colorectal Surge, 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

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

Seeking a Patient Referral Specialist for handling 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.

What you will do in this role:

• 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 patient's 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.

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

MSO - Houston Colorectal Surge, 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.

Supporting HCA Healthcare's 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance 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 costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Patient Referral Specialist opening. Qualified candidates will be contacted for interviews.

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.