Referral Specialist OBGYN

Banner Health Corporate; United States; On-site; USD 36,000 - 48,000; Full time

Job summary

Banner Health Corporate seeks a Referral Specialist in Phoenix to coordinate referral orders for specialty services and diagnostics, ensuring clinical information is ready for payor authorization. The role tracks referrals, closes patient care gaps, and communicates with patients, providers, and payers to ensure timely care.

The position supports OB-GYN services in a Magnet-recognized center, with a Monday–Friday daytime schedule (7:00am–5:30pm) in a leading academic medical environment.

Qualifications

• High school diploma or GED required.
• 1 year of direct patient interaction/experience in medical, insurance, or healthcare setting.
• Knowledge of HIPAA regulations.
• Strong customer service orientation and problem-solving skills.
• Effective verbal and written communication and ability to manage competing priorities.
• Proficiency with commonly used office software.

Responsibilities

• Schedule appointments for specialty services and testing per provider request.
• Act as liaison between patients, providers and staff for referral needs and follow-up.
• Provide clinical information for payor authorization and timing of services.
• Track referrals and follow up at 30/60/90 day intervals to close care gaps.
• Understand medical terminology and insurance environment; stay updated on payor regulations.
• Collaborate with external referral sources and community resources.

Skills

Customer service

Communication

Prioritization

Problem solving

Teamwork

Education

High school diploma/GED

Tools

Office software

Job description

Job Overview

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 the University 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

• 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


• 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.


• 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


• 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


• 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


• 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


• 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 Statement: EEO/Disabled/Veterans

EEO/Disabled/Veterans Banner Health supports a drug-free work environment.