Referral Specialist

✨ Why Join Primary Care Partners? We Take Care of You While You Care for Others! ✨

At Primary Care Partners, we believe that taking care of our team is just as important as taking care of our patients. That’s why we offer:

• 100% Employer-Paid Health Insurance Premiums – Your health matters to us.
• ️ Paid Vacation and Sick Time – Because rest and recovery are essential.
• • ️ A Strong Commitment to Work-Life Balance – We strive to create a positive, supportive environment where every individual can thrive both professionally and personally.

Job Summary:

Primary Care Partners is dedicated to providing the most exceptional primary care services to our patients. To accomplish this goal, we continuously promote advancements in clinical practice and the utilization of state-of-the-art technology benefiting both patients and employees.

We are seeking a Referral Specialist to join our team! This position is primarily responsible for the tracking of outstanding patient referrals and follow up calls to patients to secure an appointment, the maintaining of referral folders including archiving, entry into patient accounts, and providing direct communication with referring provider offices on status on pending referral requests.

Essential Duties and Responsibilities:

• Organize medical records for referral, checking for completeness and accuracy.
• Sending referrals/authorization via chart2pdf email, electronic, insurance portal, authorization system, and fax.
• Register referrals for insurance company approval.
• Complete the colonoscopy/EGD worklist.
• Complete paperwork and fax Sleep Studies for authorization.
• Complete the worklist according to protocol time constraints, send ASAP/STAT first, task staff & providers for changes or clarification, create summary of care, annotate in chart , fax referrals, check fax system for completion for Primary Care Partners (6 offices, 66 providers, to over 1000 specialists/offices). Follow STAT referrals to point of scheduling.
• Altera EHR tasks-monitor tasks throughout the day, and respond to tasks in a timely manner, with accurate and complete annotation in charts
• Monitor voice mail throughout the day and respond to patients/families, staff, providers, and specialists offices. Calls prioritized according to stated needs. Communicate with involved parties through phone, patient portal, or EHR tasks. Annotation entered into EHR chart.
• Responsible for faxes, tasks, voicemails, worklist, and referral loop
• Submit Child Find 0-3 yrs on state internet website.
• Follow RMHP EConsult program and attach documents as needed for providers as well as submit consult to billing.

Miscellaneous:

• Attend collaborative monthly team meetings, focused group meetings, and trainings as available.
• Collaborate with providers, staff, patients, families, and specialists offices to trouble shoot barriers to obtaining referral acceptance.
• Pilot special projects for PCP IT, Phressia, and RMHP.
• Collaborate and cooperate with referral team, office managers, care coordinators, chronic care coordinators, and prior authorization team to optimize work processes.
• Communicate with triage, providers, back office staff regarding issues and changes needed for a referral. Annotating changes in chart.
• Generating and editing referrals as needed.

Work Experience:

Proven ability to process high volume of data efficiently. Previous medical office or healthcare setting experience preferred.

General Requirements:

Computer Skills: Highly proficiency in Microsoft Word, Microsoft Excel, and e-mail. Prefer skills in using referral software, using health plan web sites and familiarity with electronic medical records.

Education Requirements:

High School Diploma