Referral and Authorizations Specialist

Position Summary: In accordance with the Center’s policies and procedures, the referral Specialist functions under the direction of the referral Coordinator. This position is responsible for the planning implementation and follow-up of patient referrals generated by the primary care physician.

 Essential Functions: 

• Develops a comprehensive reference file of patient referral sources; serves as a resource person to other staff regarding the referral process 

• Utilize physician orders and medical assistant or nursing skills to prioritize patient referral needs 

• Schedule referral appointments timely 

• Follows assigned rotation schedule to specific centers to process referrals; responsible for managing referrals at rotation sites to prevent back-log

 • Initiates and assists in health education for patient and family 

• All routine referrals to be initiated within 10 working days; ASAP referrals initiated within 3 working days; urgent referrals to be initiated within 24 hours; mail appropriate copy of referral to third party payer 

• Thoroughly and accurately document referral efforts and outcomes; track referrals to ensure follow-up compliance 

• Keep accurate, complete and current referral logs

 • Collaborates with Case Managers and managed care providers to determine patient eligibility 

• Identifies referrals to be schedule by other staff in accordance with the referral degree of difficulty 

• Order referral forms from respective sources, as assigned 

• Effectively utilize EHR to assist in the comprehensive scheduling and follow-up of referrals

 • Alert appropriate care team members to challenges with referral funding 

• Communication of referral status to physician, as appropriate

 • Keep current in changes in managed care policies as related to the processing of referrals

 • Collaborate with Medical Social Worker to identify and address financial assistance needs of patients to access specialty care

 General Duties: 

• Support the Mission, Vision and Values of Tampa Family Health Centers 

• Performs clerical duties for Referral Service department including:

 • Responds to calls in a timely manner 

• Assists clinical team with urgent referrals as needed 

• Assist internal and external customers with All referral needs

 • Interact with clinicals staff 

Knowledge and Experience:

 • Strong communication skills, both oral and written

 • Detailed -Oriented 

• Ability to multi-task in a fast-paced environment 

• Strong organization and prioritization skills 

• Minimum (1) years’ referral experience

 • Great work ethic 

 Education, Certification Training and License: 

• High School graduate or equivalent

• Prefer experience with Microsoft applications

 • Prefer previous medical front desk (verification/eligibility)