Referral Specialist

Rural Health Group, Inc.; Roanoke Rapids (NC); On-site; USD 36,000 - 48,000; Full time

Job summary

Rural Health Group is seeking a full-time Referral Specialist for the RHG Halifax Medical Specialist clinic in Roanoke Rapids, NC. The role focuses on coordinating referrals, obtaining prior authorizations, and ensuring timely processing of patient referrals.

The ideal candidate will have outpatient office experience, strong multitasking abilities, and excellent communication skills. E-Verify and background checks are part of employment.

Qualifications

• High school diploma or GED required.
• Outpatient physician office experience strongly preferred.
• Ability to multi-task and work efficiently in a potentially stressful environment.
• Ability to apply common sense understanding when carrying out detailed written or oral instructions.
• Strong communication and organizational skills are essential.

Responsibilities

• Schedule STAT/URGENT referrals and track high-risk referrals.
• Obtain prior authorization from insurance carriers for ordered tests and specialty referrals.
• Maintain confidentiality of patient health records per applicable laws.
• Process referrals timely, sorting by urgency and date.
• Refer patients to specialists based on medical, financial, and transportation resources.
• Document and enter referrals in patients’ health records.
• Review referral details with patients and explain responsibilities.
• Verify documentation supports the referral and related workups.
• Assemble and forward complete documentation to appropriate providers.
• Track all referrals ongoingly and monitor status.
• Handle incoming calls and respond to information requests from patients and external sources.
• Participate in quality improvement teams/meetings.
• Monitor high-risk and current cancers.

Skills

Good Judgment

Communication/Customer Service/Team—_…

Passion

Honesty

Responsibility

Job-Specific Skill Set

Education

High school diploma or GED

Tools

eClinicalWorks

Microsoft Office

Practice management systems

Job description

Rural Health Group is seeking a full-time Referral Specialist at our RHG at Halifax Medical Specialist clinic in Roanoke Rapids, NC.

Successful candidate must demonstrate the Rural Health Group Core Competencies, which include:

1. Good Judgment
2. Communication/Customer Service/Teamwork
3. Passion
4. Honesty
5. Responsibility
6. Job-Specific Skill Set

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

• Responsible for scheduling STAT/URGENT referrals, tracking referrals andtracking hig risk referrals and actions
• Responsible for obtaining prior authorization from Insurance carriers for ordered Diagnostic Testing/ Procedures and ordered Specialty Referrals.
• Maintains confidentiality of patient health records and other information as required by applicable laws
• Processes referrals in a timely fashion, including sorting and processing referrals by indicated urgency and date
• Refers patients to specialists based on available medical, financial, and transportation resources
• Documents and enters all referrals appropriately in patients’ health record
• Reviews with patients the referral details including their own responsibilities
• Verifies that providers have sufficiently documented the reason for the referral and have done the appropriate workups prior to the referral
• Assembles and forwards complete and accurate documentation
• Maintains ongoing tracking of all referrals
• Handles incoming phone calls and responds to requests for information from patients and outside sources
• Performs other duties as assigned
• Actively participates in quality improvement teams/meetings
• Monitors and tracks high risk and current cancers.

REQUIREMENTS

• High school diploma or GED.
• Outpatient physician office experience strongly preferred
• Ability to multi-task and work efficiently in a potentially stressful environment
• Ability to apply common sense understanding when carrying out detailed written or oral instructions
• Ability to establish and maintain positive, effective, professional relationships with patients, providers, coworkers, and superiors
• Possess knowledge of modern office equipment, Microsoft Office software programs, medical practice management systems,and basic computer skills (including the ability to type)
• Must be able to quickly learn to use eClinicalWorks electronic health record system
• Must have excellent organizational, telephone, and verbal and written communication skills
• Physical Demands: Must be able to sit for long periods of time. Must be able to lift 25-50 pounds. Must be able to ambulate for extended periods of time.
• Embraces the team concept; encourages and models healthy, productive team behavior
• Bilingual (English/Spanish) is a plus, but not required - applicants who may serve in a translating capacity will be required to take a language assessment

EOE. Federal and State Criminal Background Checks and Drug Screen required for all positions. Influenza vaccine is also acondition of employment.

E-Verify Notice: After accepting employment, new hires are required to complete an I-9 form and present documentation of their identity and eligibility to work in the United States.