Referral Specialist OBGYN

Banner Health; United States; On-site; USD 42,000 - 60,000; Full time

Job summary

Banner Health in Phoenix, AZ, seeks a Referral Specialist in the OB-GYN department to coordinate referrals for continued care, obtain payor authorization information, and ensure timely communication with patients and providers.

The role requires at least 1 year of referral experience, strong customer service, HIPAA knowledge, and proficiency with common office software. Schedule is Monday–Friday, day shift at Banner University Medical Center Phoenix.

Qualifications

• High school diploma or GED or equivalent.
• 1 year of direct patient interaction/experience.
• Knowledge of HIPAA regulations.
• Strong customer service focus and ability to problem solve.
• Proficient with commonly used office software.

Responsibilities

• Coordinate referral orders for continued care and diagnostic testing.
• Provide clinical information needed for payor authorization.
• Track referrals and follow up to close patient care gaps.
• Educate patients, families, and coordinate with providers.
• Maintain updated knowledge of insurance regulations and resources.
• Collaborate with external referral sources and internal teams.
• Communicate with patients, physicians, and third party payors to prioritize tasks.

Skills

Customer service

HIPAA knowledge

Verbal & written communication

Office software proficiency

Education

High school diploma or equivalent

Tools

MS Office

Job description

Primary City/State:

Phoenix, Arizona

Department Name:

OB-GYN

Work Shift:

Day

Job Category:

Administrative Services

The academic medicine difference. At the center of Banner – University Medicine is patient care, research, and teaching. Join a nationally recognized health care leader and experience the future of medicine today.

The Obstetrics and Gynecology (OB/GYN) department at Banner University Medical Center Phoenix, also known as theUniversity Medicine Women’s Institute, offers a comprehensive range of services for women’s health, including prenatal care, delivery, gynecological care, and more.

As a Referral Specialist you will have the opportunity to provide direct support to our patients assisting with coordinating referrals for women’s health. Seeking at least 1 yr of experience with referrals.

The schedule is Monday-Friday from 7:00am-5:30pm

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.