What are the responsibilities and job description for the Referral Specialist position at Sunset Health?
Job Details
Description
Description
- Handle incoming clinical tasks, phone calls, and in-person requests, reviewing clinical history and obtaining notes for provider when needed; ensuring correct payer, CPT, and ICD-10 codes are on referral requisition.
- All referrals are processed in a timely and efficient manner and according to the referral policies and procedures; insurance benefit and eligibility is confirmed prior to processing the referral, ensuring patient is assigned to a SH provider.
- Arrange appointments with external and internal specialties, faxing referral requisition and any pertinent information.
- Patients, or parent/legal guardian, are notified verbally regarding their appointment date, time, location, special instructions, and out-of-pocket expenses if applicable.
- Follow up on referrals pending prior authorization/appointment is done at least weekly, documenting all efforts made in EHR.
- Use of good time-management skills; contributing to increased productivity.
- Actively participating in staff meetings and working toward accomplishing department goals and objectives; ability to work well with team members. Accomplishing related results as needed.
- Statistics of all referrals processed are reported weekly to the Practice Manager.
- Use multiple software systems for insurance verifications and referral processing purposes.
- Demonstrates an understanding of organizational structure by utilization of appropriate channels of communication regarding all facets of departmental activities.
- Use of computers, fax/copy machines for the exclusive uses of clinic business; keeping work areas clean and organized at all times.
- Adhere to HIPAA confidential practices for patient information.
- Adhering to all Sunset Health policies and procedures.
- Performs other duties as assigned.