Job Description Summary

The Referral Management Specialist II reports to the Patient Access Scheduling Supervisor. Under general supervision, the Patient Access Specialist position schedules appointments for multiple specialties and primary care physicians in a call center environment utilizing an automated scheduling system. This role serves as expert in all healthcare scheduling/access areas as related to provider specific templates and specialties. This position works closely with departmental, clinical, physicians and division staff to assist potential customers in navigating the system to gain access and referral information for medical care at MUSC. This position triages patient calls according to established algorithms, answering questions, resolving issues and referring to appropriate clinical team for clinical issues as necessary. This role functions as the primary patient advocate between medical team and consumer by coordinating their requests and satisfying needs in one phone call. This positions performs quality data collection of accurate information including demographic, physician, insurance, employment, next of kin, emergency contacts and other miscellaneous information needed to complete the patient’s information. This role displays highest level of customer service, attentiveness, and consideration possible in all areas.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC005041 SYS - Corp Case Management - CHS Direct

Pay Rate Type

Hourly

Pay Grade

Health-19

Scheduled Weekly Hours

40

Work Shift

Job Description

Obtains and processes signed physician orders/referrals to ensure accurate clinical documentation for care delivery, specialty and outpatient ancillary referrals. In addition, the referral coordinator will conduct online insurance eligibility/benefit verification, obtain pre-certification/authorization, referral clearance and financial education on designated cases. As appropriate; notifies patient/guarantor, specialist, referring provider, etc., with pertinent information, inclusive of, but not limited to clinical documentation, referral status, follow-up, etc.

Additional Job Description

Minimum Training and Education: Bachelor’s degree from an accredited college/university; or a high school diploma or equivalent (GED) and two years experience in a Medical Office, Call Center, and/or customer service business environment and a minimum of 6 months satisfactory work experience in MUHA scheduling is required. The ability to prioritize and coordinate multiple tasks in a busy environment necessary. Extensive experience with computers and technology including Windows, Excel, and Intranet/Internet navigation tools, as well as system content, essential. Strong demonstrated verbal, written, problem solving and presentation skills. Ability to work in self-directed manner while interacting with customers, physicians and departmental partners.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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