Patient Referral Specialist

HCA Healthcare, Inc.; Myrtle Beach (SC); Sur place; USD 50 000 - 65 000; Plein temps

Avantages offerts par ce poste

Comprehensive medical, prescription, &

Vision, dental, behavioral health

Résumé du poste

Coastal Cardiovascular Surgery, part of the HCA Healthcare family, is seeking a Patient Referral Specialist. The role focuses on processing physician, hospital, and outpatient referrals, scheduling patients, and obtaining insurance authorization to guide coverage and approvals.

The position requires teamwork with diagnostic and surgical service areas, offices, and hospitals to ensure timely, accurate appointments and complete referrals while adhering to privacy and HIPAA regulations.

Qualifications

• High School Diploma or GED required.
• One year of referral coordination experience preferred.
• Ability to determine insurance eligibility and obtain authorizations.

Responsabilités

• Process physician, hospital, and outpatient referrals.
• Schedule patients and obtain insurance authorizations.
• Ensure accuracy of patient demographics and medical information.
• Enter referrals and patient data into EMR.
• Communicate scheduling details and prep instructions to patients.

Connaissances

Attention to detail

Communication

Healthcare experience

Formation

High School Diploma or GED

Outils

EMR systems

Description du poste

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized.

Job Summary And Qualifications

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

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.

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

Coastal Cardiovascular Surgery, 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

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.

"There is so much good to do in the world and so many different ways to do it."- 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.