Bilingual Referrals Specialist

Dracut MA, not remote

$18 / hr

Hours 8 - 5 : 30pm

MUST BE BLINGIUAL IN SPANISH / ENGLISH

Under the supervision of the Patient Services Supervisor, the Referral Specialist performs all functions necessary to ensure patients have been cleared for specialty service visits.

Referral Specialist will ensure the effective management of all medical referrals and perform a variety of tasks including, processing, prior authorizations, scheduling and tracking of medical referrals for clinic patients to be compliant with Patient Center Medical Home requirements to ensure patient safety.

As an integral member of the health care team, collaborates with other clinic Referral Specialist, Clinicians and other support staff.

Job Responsibilities and Performance Standards :

o Monitors electronic referral boxes in EMR and Faxcom throughout the day to capture referral requests

o Prepares and processes all referral and pre authorization paperwork

o Gathers pertinent information as needed via EMR or from clinical team

o Contacts various clinics, facilities, companies to obtain information to accurately complete referral / pre authorization requests

o Utilizes third party payer / insurance portals; has a detailed knowledge of insurance providers, their portals and their expectations for authorization approval

o Calls patient within 48 hours of initial referral to provide update

o Flags Provider and or MA within 48 hours of initial referral to provide update

o May schedule specialty appointments directly on behalf of patient

o Calls patient within 48 hours of receiving specialty appointment and mails appointment letter

o Utilizes EMR functions to document all pertinent information

o Organizes and prioritizes workload

o Maintains confidentiality by following all applicable HIPAA regulations

o May be directed to provide support to other team members during vacation or other absences

o Maintains specific workflows for specialized tests and / or procedures

o Is detail oriented and works with a high level of accuracy in every aspect of the job

o Is a team player who demonstrates an enthusiastic, caring and compassionate commitment to the patient and their unique circumstances

o Demonstrates outstanding interpersonal skills, time management skills, and an ability to meet or exceed established productivity standards

o Maintains confidentiality and protects sensitive data at all times

o Adheres to organizational and department specific safety standards and guidelines

o Works collaboratively and supports efforts of team members

o Demonstrates exceptional customer service and interacts effectively with clinicians, patients, residents, visitors, staff and the broader health care community

o On a regular basis participate in ongoing quality improvement activities related to individual, team, and organizational performance improvement.

o Travel between sites may be required

o Performs all and any additional duties as assigned

Qualifications : Experience

Experience

o Medical or Administrative training preferred.

o Minimum 1 year related experience working in hospital or other clinical environment.

o Medical terminology and training in EMR systems required.

o Excellent communication and customer service skills required.

o Must be Bilingual, fluent in Spanish and English.

o Ability to deal with stressful situations, and working flexible hours that include evenings and weekend is necessary.

Education

o HS Diploma or GED Certificate required

Physical Environment

o Physical surroundings are pleasant and comfortable with minimal exposure to injury or hazards.

Social / Psychological Conditions

o Regular volume of work and deadlines impose stress on routine basis.

o Frequent interruptions

o Some occasional stress due to periodic or cyclical workload

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