Referral Specialist

Central Florida Health Care, Inc.; Winter Haven (FL); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Federal Student Loan Forgiveness

Excellent medical benefits

401k Retirement Plan

Paid Time Off

Holidays

Malpractice Insurance

Job summary

Central Florida Health Care, Inc. is seeking a Referral Specialist to manage all aspects of the patient referral process, coordinating referrals ordered by CFHC providers, verifying third-party information, obtaining referrals, and tracking them to ensure timely care.

The role requires a high school diploma (certified medical assistants preferred) and strong communication and organizational skills to support a team-oriented practice and maintain compliance with policies and regulations.

Qualifications

• Certified and Registered Medical Assistants preferred.
• High School graduate or GED required.
• Experience preferred; computer literacy.

Responsibilities

• Be familiar with CFHC’s policies and procedures, and state/federal regulations.
• Perform the duties of a referral specialist competently.
• Report to COO any information affecting patient care or CFHC liability.
• Attend mandatory CFHC meetings and collaborate with the clinical team.
• Maintain professional appearance and carry out additional duties as assigned.
• Coordinate referrals, obtain authorizations, schedule appointments, and track referrals.

Skills

Certified Medical Assistant

Medical terminology

Insurance knowledge

Verbal and written communication

Time management

Team oriented

Education

High School Diploma or GED

Job description

Reports to: Referrals Specialist Supervisor

Position Summary:

The Referral Specialist is responsible for performing all aspects of the patient referral process including coordinating and completing referrals ordered by CFHC providers, acquiring and verifying third party information for referrals, obtaining referral appointments, and tracking referrals.

Qualifications:

• Certified and Registered Medical Assistants preferred
• High School graduate or GED required
• Experience preferred Computer literacy

Knowledge and Skills:

• Knowledge of basic medical terminology
• Knowledge of various insurance programs (example, Medicaid)
• Effective verbal and written communication skills
• Organized and able to manage competing priorities
• Resourcefulness in problem solving
• Able to take and follow through with delegated tasks
• Team oriented

RESPONSIBILITIES AND PERFORMANCE EXPECTATIONS:

may include, but are not limited to, the following:

• Be familiar with CFHC’s program philosophies, goals and objectives. Be cognizant of and comply with all CFHC’s policies and procedures, as well as state and federal regulations.
• Be competent in performing the duties of a referral specialist.
• Report as needed to COO any pertinent information or situations that impact on patient care or CFHC liability.
• Attend and participate in mandatory CFHC meetings (Center Specific meetings, corporate meetings, and other meetings as designated by the COO or CEO).
• Demonstrate ability to work cooperatively with other members of the clinical team. Be supportive of coworkers.
• Maintain a neat and professional appearance at all times.
• Carry out any other activities deemed appropriate by the COO or CEO.

DUTIES OF A REFERRAL SPECIALIST:

include, but are not limited to, the following:

• Coordinate all aspects of completing referrals ordered by CFHC providers
• Complete referrals in a timely manner; STAT referrals must be completed by end of business day, URGENT referrals within 24 hours, and ROUTINE referrals within 72 hours
• Obtain appropriate authorizations from insurance companies sending necessary documentation from the patient’s medical record as required
• Schedule referral appointments for patient (when applicable) ensuring proper paperwork is faxed to the specialist or given to the patient to take to the appointment (example, labs, x-ray reports, progress notes)
• Notify patient of scheduled referral appointment
• Document appropriately and thoroughly
• Track all referrals accordingly to improve the quality and continuity of care provided to patients. This includes, but is not limited to, initiating reminder calls to patients prior to their scheduled appointment and obtaining the referral report from the specialist.
• Notify the ordering provider and/or Health Services Manager of any problems in obtaining a patient’s referral, including issues with obtaining authorizations from third party payors or making appointments with a specialist, patient refusal of a referral, or patient no show to scheduled referral appointment
• Maintain specialty provider list including payor sources they accept
• Review referral log weekly to ensure completion of all referrals
• Other duties as assigned by Health Services Manager

The job description is not intended to be all-inclusive, and employee will also perform other reasonable related business duties as assigned by supervisor.

BENEFITS:

• Federal Student Loan Forgiveness:
• PSLF – 10-year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven
• Excellent medical, dental, vision, and pharmacy benefits
• Employer Paid Long-Term Disability Insurance
• Employer Paid Life Insurance equivalent to 1x your annual salary
• Voluntary Short-Term Disability, additional Life and Dependent Life Insurance are available
• Malpractice Insurance
• Paid Time Off (PTO) – 4.4 weeks per year pro-rated
• Holidays (9.5 paid holidays per year)
• Paid Birthday Holiday
• CME Reimbursement
• 401k Retirement Plan after 1 year of service (w/matching contributions)
• Staff productivity is recognized and rewarded

PHYSICAL REQUIREMENTS

• Requires 80% or more time spent sedentary.
• Independently mobile.
• Ability to lift weight equivalents that would be required with re positioning equipment and lifting supplies.
• Ability to adapt and function in varying environments of workload, patient acuity, work sites, and work shifts.

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.