Referrals Specialist
Lowell, MA, United States
Description
Process incoming and outgoing referrals. Responsible for scheduling specialty appointments for health center patients and informing patients of date, time and location of appointments. Respond to inquiries from patients, staff, internal and external physicians, hospitals, other medical groups and third-party carriers. Maintain data and referral tracking system. Work collaboratively with other members of the health care team in order to provide superior patient care delivery.Provides overall excellent customer service.
MAJOR RESPONSIBILITIES
Process incoming/outgoing referrals sent via the electronic medical record (EMR) from providers.
Upon receiving a request for a referral, verify insurance coverage and obtain approval as needed.
Research and ensure that the specialist referring to accepts the patient's insurance plan.
Contact the specialty office and schedule an appointment for the patient.
Assemble paperwork, required medical information and submit to specialty office as needed.
Respond to providers via telephone encounters and actions within the EMR as needed.
Respect and maintain the privacy and dignity of patients/clients, ensuring patient confidentiality at all times.
Evaluate referrals for accuracy and completeness while supporting physician networks.
Documents pertinent information in the management system and routes information as needed.
Interact with patients via various methods, including phone, text, and portal regarding questions about referrals/appointments.
Ensure that all required forms are obtained, completed, and signed.
Ensure that referrals are processed in a timely manner in accordance with health center policies.
Maintains current knowledge of referral processes, health center systems, and changes.
Participate in staff and educational meetings/trainings.
Provide excellent customer service to both external customers and internal customers.
Perform other work-related duties as assigned.
KNOWLEDGE & SKILLS
Must be able to work independently and as part of a team. Possess good communication and interpersonal skills and is resourceful in problem-solving. Must be detail oriented, organized, and have the ability to multi-task and manage competing priorities. Accountable to take on and follow through with delegated tasks. Bi-lingual in English and Spanish, Portuguese or Khmer preferred.
EDUCATION & EXPERIENCE
High school diploma or equivalent, two years office experience in a health care setting preferred. Knowledge of medical terminology is required. Knowledge of the health care system and insurance eligibility is strongly preferred. Experience working with diverse communities and understanding of multicultural beliefs, practices, and cultures is preferred. Data entry, computer, and phone skills are required. Knowledge of Electronic Medical Records (EMR) is a great asset.