Referral Specialist - Community Clinic * Days - 40hrs/wk.

University of Michigan Health-West; Wyoming (MI); On-site; USD 40,000 - 56,000; Full time

Job summary

University of Michigan Health-West is seeking a Referral Specialist for our community clinic to coordinate internal and external referrals, schedule appointments, and gather necessary information for authorizations.

Under management direction, you will work closely with physicians and care teams, enter referrals into EMR, validate insurance, and ensure timely responses to providers and patients. This role is a full-time day shift with no on-call.

Qualifications

• High School education or equivalent.
• At least 1 year in a medical office or coordinating referrals.
• Knowledge of medical terminology.
• Ability to work independently and with minimal supervision.
• Knowledge of medical record content and sequence.
• Training or experience in medical coding and managed care insurance plans.
• Knowledge of appointment scheduling process.
• Strong interpersonal and communication skills.
• Ability to prioritize, maintain accurate records and meet deadlines.
• Excellent customer service skills.

Responsibilities

• Schedules and coordinates specialist appointments, procedures and tests.
• Monitors EMR orders to ensure providers enter information correctly.
• Validates insurance coverage and processes insurance authorizations.
• Assembles information concerning patient’s clinical background and referral needs.
• Enters and tracks all referral requests in the EMR or other information system as required
• Responds and documents requests from providers and patients in a timely manner.
• Participates in process improvement activities to enhance referral process and workflow.
• Performs other duties as assigned.

Skills

Interpersonal skills

Verbal communication

Written communication

Medical terminology

Medical coding

Managed care knowledge

Appointment scheduling

Record keeping

Education

High School diploma or equivalence

Job description

Referral Specialist - Community Clinic * Days - 40hrs/wk.

Requisition #: req12800

Shift: Days

FTE status: 1

On-call: No

Weekends: No

General Summary:

Under the direction of management, the Referral Specialist coordinates internal and external referrals ordered by providers. This includes completing referrals, scheduling appointments, acquiring and verifying third party information for authorizations and tracking referrals. The Referral Specialist works closely with physicians and other members of the care team.

Requirements:

• High School education or equivalent
• One year of experience in a medical office and/or prior experience coordinating referrals
• Knowledge of medical terminology
• Able to work independently and collaboratively with minimal supervision
• Knowledge of medical record content and sequence
• Training or experience in medical coding and managed care insurance plans
• Knowledge of appointment scheduling process
• High level of interpersonal skills
• Communicate effectively, both verbal and written
• Able to prioritize, maintain accurate records, and work under deadline
• Excellent customer service skills

Essential Functions and Responsibilities:

1. Schedules and coordinates specialist appointments, procedures and tests done internally or externally.
2. Monitors EMR orders to ensure providers enter information correctly.
3. Validates insurance coverage and processes insurance authorizations.
4. Assembles information concerning patient’s clinical background and referral needs.
5. Enters and tracks all referral requests in the EMR or other information system as required
6. Responds and documents requests from providers and patients in a timely manner.
7. Participates in process improvement activities to enhance referral process and workflow.
8. Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures for patient care, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management.