Referral Specialist

Rockhill Orthopaedic, PC; Lee's Summit (MO); On-site; USD 23,000 - 32,000; Part time

Job summary

Rockhill Orthopaedic Specialists is seeking a part-time patient services specialist to complete referral forms and assist in scheduling based on insurance requirements. The role coordinates with referring offices to obtain pre-certifications for imaging across outpatient facilities and helps verify orders with radiology staff to streamline patient flow.

The ideal candidate will have strong communication, patient service experience, and familiarity with Epic or similar medical software, with a

Qualifications

• Must enjoy interacting with people and have good verbal communication skills.
• Customer service experience required; healthcare environment preferred.
• Understanding of medical software, such as Epic, strongly preferred.

Responsibilities

• Check eligibility, obtain insurance authorizations and referrals prior to patient appointment.
• Obtain authorizations for CT, MRI, and physical therapy orders.
• Obtain authorization, benefits and schedule injections.
• Obtain authorization and benefits for DME’s.
• Authorize and schedule STAT appointments.
• Send therapy orders to requested facility.
• Send referral and records to specialty physicians.
• Follow up on CT and MRI appointments.

Skills

Verbal communication

Customer service

Teamwork

Education

High School diploma or equivalent

Tools

Epic

Job description

Rockhill Orthopaedic Specialistshas been a pillar of musculoskeletal care in the Kansas City region for over 70 years, with an impressive tradition and commitment to not only providing exceptional healthcare services to our patients, but also an overall dedication to the well being of our community.

Position Summary –

This specialist completes referral forms and assists in scheduling appointments based on patient insurance requirements. This role works with multiple referring offices to obtain and document pre-certifications for imaging studies for multiple outpatient facilities. Interact with radiology technologist to assist in verifying orders, scheduling, and assisting with patient flow.

Essential Duties and Responsibilities –

The essential functions include, but are not limited to the following:

• Check eligibility, obtain insurance authorizations and referrals prior to patient appointment
• Obtain authorizations for CT, MRI, and physical therapy orders
• Obtain authorization, benefits and schedule injections
• Obtain authorization and benefits for DME’s
• Authorize and schedule STAT appointments
• Send therapy orders to requested facility
• Send referral and records to specialty physicians
• Follow up on CT and MRI appointments
• Work with clinic to obtain authorization by doing peer to peer
• Communicate verifications for coordinating authorization of scheduled tests or injections

Specifications / Qualifications (Knowledge, Skills, Abilities) –

Must enjoy interacting with people, be able to relate well to a variety of personalities and have good verbal communication skills. Have a cheerful disposition with a calming affect when interacting on the telephone. A self-motivated individual who can work well with interruptions, understands the need to be precise with information-gathering tasks and is able to convey instructions effectively. Enjoys working with a team.

Typical Physical Demands – The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Must be able to use a variety of office equipment including copiers, printers, and fax machines.

Work Environment – Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. Ability to sit for prolonged periods of time and type on keyboard. Ability to adapt to rapidly changing environments while meeting our customer’s demands and deadlines.

Work Hours –This is an hourly part-time position, 20-28 hours per week; hours may vary.

Education – High School diploma or equivalent required.

Work Experience – Understanding of medical software, such as Epic, strongly preferred. Customer service experience required. Prior experience in a healthcare environment preferred.

Expectations and Responsibilities of All Employees:

• Philosophy
• Supports the facility’s ideology, mission, goals, and objectives
• Performs in accordance with the facility’s policies and procedures
• Follows the facility’s standards for ethical business conduct
• Conducts self as a positive role model and team member
• Recognizes patients’ rights and responsibilities and supports them in performance of job duties
• Respects patients’ rights to privacy, dignity, and confidentiality
• Actively participates in facility committees, meetings, in-services, and activities.
• Demonstrates flexibility to perform other duties as assigned

2. Communication

• Communicates effectively and professionally with patients, visitors, physicians, and coworkers
• Interacts with others in a positive, respectful, and considerate manner
• Uses facility resources appropriately and avoids wasteful practices
• Maintains operations by following policies and procedures; reporting needed changes and wasteful practices
• Analyzes work area and makes recommendations for potential cost-effective improvements

4. Compliance Program

• Contributes to the progress and development of the organization’s adopted compliance program
• Ensures compliance with private payor, workers compensation and government regulations
• Ensures compliance of the clinic with State and Federal regulations such as HIPAA, OSHA regulations
• Ensures that records are stored securely and handled in compliance with HIPAA privacy and security regulations, as applicable

5. Safety/Risk-Management Program

• Adheres to safety policies and procedures in performing job duties and responsibilities
• Maintains responsibility for safe work area by reporting to safety officer or designee observed or suspected safety violations, hazards, and policy/procedure noncompliance
• Responds to emergency situations with competence and composure
• Reports observed or suspected medical emergencies, notifies appropriate personnel, and responds appropriately
• Identifies facility emergency situations (e.g., fire, disaster) and notifies appropriate personnel and external agencies

6. Professional Competence

• Participates in continuing education and other learning experiences
• Shares knowledge gained in continuing education with staff
• Maintains membership in relevant professional organizations and/or maintains certification with relevant certifying body
• Seeks new learning experiences by accepting challenging opportunities and responsibilities
• Welcomes suggestions and recommendations

Note: The job duties listed in this job description may not be inclusive of all requirements of this position. The above statements are not to be construed as an exhaustive list of all responsibilities, skills or duties, requirements, efforts, or working conditions associated with the job.

While this is intended to be accurate reflections of the current job, management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change (i.e., emergencies, changes in personnel, workload, rush jobs, or technological developments).

This document does not create an employment contract and employment is “at-will”.