Referral Specialist

Rochester Regional Health; United States; Remote; USD 10,000 - 60,000; Full time

Job summary

An established healthcare provider is seeking a Referral Specialist to enhance patient care through effective scheduling and authorization processes. This role involves coordinating with various stakeholders to ensure timely access to specialized testing, such as MRI and CT scans. The ideal candidate will excel in customer service, possess strong multitasking abilities, and be proficient with medical terminology and software applications. Join a dedicated team committed to providing exceptional care and support to patients, while contributing to the efficiency of healthcare delivery in a collaborative environment.

Qualifications

• High school diploma or GED required, AAS in related field preferred.
• Proficiency with Excel and Word, along with medical terminology.

Responsibilities

• Coordinate testing with physicians, patients, and payers.
• Obtain authorizations and document interactions in EMR.
• Notify patients of scheduled procedures and instructions.

Skills

Customer Service

Multitasking

Medical Terminology

Orthopedic Terminology

Computer Proficiency

Education

High School Diploma or GED

AAS in Related Field

Tools

Microsoft Excel

Microsoft Word

EMR Systems

Job description

LOCATION: Rochester Regional Health Riedman Campus, 100 Kings Highway

HOURS PER WEEK: 40

SCHEDULE: Monday through Friday, 8:00AM - 4:30PM

SUMMARY

This position is responsible for scheduling and obtaining authorization/pre-certifications for, but not limited to MRI, CT, Neurology, Pain Management and other specialized testing as well as referrals to other MD Specialists and for detailing all patient and third party interaction in the patient’s EMR. Promotes and provides customer satisfaction and appropriateness of care for all assigned patients.

RESPONSIBILITIES

Greets all patients, whether in person or via the telephone, with a cheerful and helpful attitude.

Provides coordination of testing to be performed with physician, patient, facility and payer. This includes reviewing medical documents for clarity, ensuring all necessary clinical steps have been taken; works with necessary parties to obtain third-party approval.

Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing.

Refers self-pay and out-of-network patients to the appropriate resource to help with payment.

Complete pre-certification/authorization with the patient’s insurance company providing any necessary documentation.

Document authorization/pre-certification once received along with contact information of the person spoken with.

Contacts the patient and notifies them of the scheduled procedure and all necessary instructions.

Coordinates with the hospital or facility the arrival times of each scheduled patient and contacts them with this information.

Assists in reviewing and revising policies and procedures pertaining to scheduling function.

Performs other responsibilities as necessary to ensure efficiency within the practice.

Maintains operational knowledge of department equipment: telephones, computers, faxes, copier, printers, etc.

REQUIRED QUALIFICATIONS

High school diploma or GED certificate required, AAS in related field most helpful.

PREFERRED QUALIFICATIONS

Proficiency with computer software applications including Excel and Word.

Ability to maneuver through computer programs and general comfort with technology.

Medical terminology preferred.

Orthopedic terminology highly preferred.

Ability to multitask and work in a fast paced environment.

Must have excellent work habits, including a willingness to work the necessary hours to get the job done.

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

JOB TITLE: Referral Specialist

DEPARTMENT: Neuroscience

LOCATION: Rochester Regional Health Riedman Campus, 100 Kings Highway

HOURS PER WEEK: 40

SCHEDULE: Monday through Friday, 8:00AM - 4:30PM

SUMMARY

This position is responsible for scheduling and obtaining authorization/pre-certifications for, but not limited to MRI, CT, Neurology, Pain Management and other specialized testing as well as referrals to other MD Specialists and for detailing all patient and third party interaction in the patient’s EMR. Promotes and provides customer satisfaction and appropriateness of care for all assigned patients.

RESPONSIBILITIES

• Greets all patients, whether in person or via the telephone, with a cheerful and helpful attitude.

• Provides coordination of testing to be performed with physician, patient, facility and payer. This includes reviewing medical documents for clarity, ensuring all necessary clinical steps have been taken; works with necessary parties to obtain third-party approval.

• Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing.

• Refers self-pay and out-of-network patients to the appropriate resource to help with payment.

• Complete pre-certification/authorization with the patient’s insurance company providing any necessary documentation.

• Document authorization/pre-certification once received along with contact information of the person spoken with.

• Contacts the patient and notifies them of the scheduled procedure and all necessary instructions.

• Coordinates with the hospital or facility the arrival times of each scheduled patient and contacts them with this information.

• Assists in reviewing and revising policies and procedures pertaining to scheduling function.

• Performs other responsibilities as necessary to ensure efficiency within the practice.

• Maintains operational knowledge of department equipment: telephones, computers, faxes, copier, printers, etc.

REQUIRED QUALIFICATIONS

• High school diploma or GED certificate required, AAS in related field most helpful.

PREFERRED QUALIFICATIONS

• Proficiency with computer software applications including Excel and Word.

• Ability to maneuver through computer programs and general comfort with technology.

• Medical terminology preferred.

• Orthopedic terminology highly preferred.

• Ability to multitask and work in a fast paced environment.

• Must have excellent work habits, including a willingness to work the necessary hours to get the job done.

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$19.00 - $24.00

CITY:

Rochester

POSTAL CODE:

14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.
Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.

About the company

The network includes five hospitals, ElderONE/PACE and home health programs, outpatient laboratories, rehabilitation programs and surgical centers, independent and assisted living centers and skilled nursing facilities.