Referral Specialist

Valley Health Systems; Hurricane (WV); On-site; USD 36,000 - 48,000; Full time

Job summary

Valley Health Systems in Hurricane, WV is seeking a referral specialist to manage the end-to-end referral process within our health centers. You will contact insurers, coordinate with specialists, inform patients, and follow up to ensure referrals are completed.

The role emphasizes care coordination, HIPAA compliance, and clear communication with patients, families, and care teams to improve access to needed services. Typical hours Monday–Friday, 8:00am–4:30pm.

Qualifications

• High school diploma or equivalent is required.
• Excellent communication skills are essential.
• Multitasking abilities are important for this role.
• Detail oriented with strong organizational skills.
• Proficient knowledge of medical terminology is required.

Responsibilities

• Coordinate referrals by contacting insurance carriers, specialists, and patients.
• Maintain up-to-date records in the patient’s medical record.
• Use the tracking system in the EHR to keep orders and referrals current.
• Communicate referral details to patients, including date, time, location, and instructions.
• Assist in care coordination with community orgs, health plans, facilities and specialists.

Skills

Excellent communication

Multitasking abilities

Detail oriented

Medical terminology

Education

High school diploma or equivalent

Job description

Job Summary:

The referral specialist is responsible for carrying out the entire referral process within the health center(s). The referral process includes initiating the referral by contacting the insurance carrier, contacting the specialist, contacting the patient, and follow up to see that the referral has been kept. The referral specialist plays a key role in helping patients get access to care.

Job Duties:

• Complete all necessary paperwork and other information essential to meet the patient’s insurance agency’s requirements.


• Maintain up-to-date records documenting date, time, and place of appointment or test within the patient’s medical record.


• Orders & referrals kept up to date utilizing the tracking system in the electronic health record (EHR)


• Communicate information to patients regarding date, time, location, and special instructions regarding their referrals.


• Assist in care coordination which may include obtaining test and referral results and communication with various entities including but not limited to community organizations, health plans, facilities and specialists.


• Proactively address needs of the patients and families through the concept of population management.


• Effectively communicates with all patients with specific attention to the vulnerable patient population.


• Provide self management support in the form of patient coaching and motivational interviewing when appropriate.


• Acknowledges the importance of a team approach when providing patient care.


• Communicates and coordinates effectively when providing patient care.


• Actively participates in the medical home care team which is comprised of clinical and non-clinical working together towards a common goal: delivering quality care to our patients.


• Maintain compliance with the organization’s confidentiality policy in accordance to the Health Insurance Portability and Accountability Act (HIPAA).


• Other duties as assigned.

Working Conditions:

• Position requires manual dexterity for operating standard office equipment.


• Position requires the ability to maintain concentration and attention to detail for long periods of time in order to maintain accurate records pertaining to patient and/or account information.

Qualifications:

• High school diploma or equivalent


• Excellent communication skills


• Multitasking abilities


• Detail oriented


• Proficient knowledge of medical terminology

EEO is the Law – Applicants can learn more about our equal opportunity employer status by viewing the federal EEO Know Your Rights poster.

Monday-Friday 8:00am-4:30pm