Referral Specialist Neurosurgery Clinic

bannerhealth; Phoenix (AZ); On-site; USD 38,000 - 52,000; Full time

Job summary

Banner Health in Phoenix, Arizona, seeks a Referral Specialist to coordinate referral orders for continued treatment within our high-volume Neuroscience Institute. You will ensure all needed clinical information for payor authorization is prepared and communicated to facilities and specialists.

This role focuses on tracking referrals, closing patient care gaps, educating patients and families, and partnering with providers, staff, and external resources to streamline care.

Qualifications

• High school diploma/GED or equivalent working knowledge.
• 1 year of direct patient interaction/experience in medical, insurance, or healthcare related industry.
• Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and ability to manage competing priorities. Proficient with commonly used office software.

Responsibilities

• Schedules appointments for specialty services and diagnostic testing per provider request and communicates with the patient for scheduling requirements.
• Acts as liaison between patients, providers and staff for referral and follow up needs; educates patient/family and connects to external resources.
• Provides pertinent clinical information needed for payor authorization, facility or specialist prior to services.
• Tracks and manages referrals by monitoring status and following up with patients if appointments are not kept.
• Collaborates with outside referral sources and community resources to develop additional referral sources.

Skills

Customer service

Verbal communication

Written communication

HIPAA regulations

Education

High school diploma/GED

Tools

MS Office

Job description

Primary City/State: Phoenix, Arizona

Department Name: C/P-Neurosurgery-Clinic

Work Shift: Day

Job Category: Administrative Services

Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, we want to hear from you!

This position is in our high-volume Neuroscience Institute where 19 providers with 8 specialties provide the most advanced care for conditions impacting the brain. Our expert neurologists are improving care and research for many conditions including stroke, epilepsy, multiple sclerosis and brain injury. Our skilled neurosurgeons provide cutting edge therapies for complex conditions such as brain aneurysms, epilepsy, spinal disorders and many other conditions.

As a Referral Specialist, you will be part of our in-clinic support staff and assist with clinic workload, coordinating referral orders for a continuation of treatment within our specialized clinic.

The schedule is Monday-Friday from 7:30AM-4:00PM.

University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, several unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics and has operations in multiple locations spanning across the Phoenix metropolitan city.

POSITION SUMMARY

This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.

CORE FUNCTIONS

1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients' referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision

MINIMUM QUALIFICATIONS

• High school diploma/GED or equivalent working knowledge.
• Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.
• Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.

PREFERRED QUALIFICATIONS

• Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
• Additional related education and/or experience preferred.

EEO Statement:

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.