Referrals Specialist

Borinquen Medical Centers, Inc.; Miami, Northern (FL, KY); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical/Dental/Vision/Short Term_Dis能力

Job summary

Borinquen Medical Centers, Inc. in Miami, FL is seeking a full-time Referrals Specialist to manage specialty referrals, verify pre-certifications, and coordinate appointments with outside clinics.

Under supervision, you will gather insurance information, resolve concerns, and maintain communication with patients and providers to ensure timely care. This role requires confidentiality and collaboration with physicians and hospitals.

Qualifications

• High school diploma or equivalent.
• 0–3 years of experience.
• Strong interpersonal skills.
• Ability to interact effectively with patients, administration, faculty, and staff.
• Maintain confidentiality of patient information.

Responsibilities

• Coordinate referrals to outside clinics and schedule specialty visits.
• Resolve pre-certification, registration and case-related concerns prior to appointments.
• Gather information from insurers and staff to determine financial obligations for services.
• Coordinate and follow up referrals and appointments with hospitals.
• Notify doctors about missed referral appointments.
• Attend meetings on referrals and primary care matters.
• Retrieve appointment schedules and results and distribute to providers.
• Register and track all specialty appointments in the JMH system.
• Counsel patients with information or instructions related to tests.
• Assist in processing authorized referrals for enrollees.
• Maintain policies, procedures and guidelines of BHCC.
• Develop professional rapport with health care providers in the community.
• Support supervisor and project-based work.
• Monitor fax for new referrals, attachments and results.
• Receive incoming STAT referral calls from providers and hospitals.
• Handle difficult referrals from processors.
• Take incoming specialist calls for Q/A and referral tracking.
• Forward referrals sent in error and educate sender by phone.

Skills

Interpersonal skills

Education

High School Diploma

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Miami, FL, US

Today Requisition ID: 6797

Borinquen Medical Centers in based in Miami, FL and is seeking to hire a full-time Referrals Specialist. Under general supervision, The Referrals Specialist will be responsible to e nsure patients have been cleared for specialty service office visits and track incoming consultations, as well as to schedule all referrals to outside clinics, I.E. Jackson, Bascom Palmer, etc.

TASKS AND RESPONSIBILITIES

• Work with referrals related to studies such as the following: Ultrasound, Mammograms, X-ray, MRI, MRA, CT scan, PET scan, Sleep Studies, Allergy, ENT, Colonoscopy, and Gastroenterology.
• Resolves pre-certification, registration and case related concerns prior to a patient's appointment.
• Gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided.
• Coordinates and follow ups the appointments and the referrals to the hospital.
• Notify to the doctors the patients that missed their referral appointments.
• Attends meetings in reference to referrals and primary care clinic matters.
• Retrieves JMH appointment schedules and no-shows, results and distributes to providers accordingly.
• Registers, maintains and tracks all specialty appointment on JMH system.
• Counsels and provides patients with information or instructions related to the tests.
• Find outs information from the JMH.
• Assists in processing authorized referrals for enrollees.
• Ensures those functions are done within the established policies, procedures and guidelines of BHCC.
• Develops and maintains a professional rapport with health care providers in the community (i.e.: physicians, hospitals, ancillary staff and support staff).
• Assist the supervisor as unusual problems arise; Support staff in assigned project based work.
• Monitor fax for new referrals, document attachments, and results to scan into Athena or tie to current referrals.
• Received incoming STAT referral call from Providers, MA, Specialist and Hospitals.
• Accept difficult referral from processors.
• Takes incoming specialist call for Q/A, referral tracking result.
• Forwards referral sent in error and educate sender via phone.

REQUIREMENTS

• High School Diploma, or equivalent.
• 0-3 years of experience.
• Strong interpersonal skills.
• Ability to interact effectively with consumers, administration, faculty, and staff.
• Handle the information with high level of confidentiality.

BENEFITS

• Medical/Dental/Vision/Short Term Disability