Referral Specialist Practice Based

Accountabilities: • Process and manage incoming patient referral orders, ensuring accuracy, completeness, and timely handling in accordance with established procedures.

• Monitor referral requests regularly to ensure that orders remain up to date and patients receive timely access to the appropriate healthcare services. • Communicate clearly and professionally with patients, physicians, coworkers, and other healthcare professionals regarding referral requirements and next steps. • Answer incoming phone calls promptly, respond to patient questions, provide relevant information, and schedule procedures or appointments when necessary. • Maintain referral integrity by reviewing orders, verifying documentation, and ensuring that all required information is available for processing. • Monitor voicemail messages and incoming faxes regularly, organize referral documentation, and process insurance authorizations and denials. • Verify that referral orders meet applicable insurance requirements and coordinate with relevant parties to address missing information or authorization issues. • Maintain accurate patient and referral records within electronic medical record systems and other patient database applications. • Apply medical terminology, coding knowledge, and healthcare administrative procedures to support accurate referral processing. • Deliver excellent customer service while managing sensitive, difficult, or emotionally challenging patient interactions with empathy and professionalism. • Collaborate effectively with colleagues and other departments to ensure smooth referral coordination and consistent service delivery. • Maintain strict confidentiality when handling organizational, employee, patient, family, and caregiver information. • Follow applicable healthcare regulations, organizational policies, and established procedures while supporting continuous improvements in referral operations. • Complete required orientation and training programs and perform additional administrative responsibilities as needed.

Requirements:

• High school diploma or equivalent required. • Previous administrative or clerical experience is preferred, particularly in healthcare administration, medical offices, or customer service environments. • At least one year of ICD-9 and CPT-4 coding experience is preferred. • Experience in physician office billing, patient registration, appointment scheduling, healthcare call centers, or related administrative functions is an advantage. • Familiarity with electronic medical records (EMR), patient database systems, and healthcare referral management processes. • Knowledge of medical terminology and basic healthcare administrative procedures. • Understanding of ICD-9/ICD-10 and CPT-4 coding systems is preferred. • Intermediate to advanced proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook, as well as general internet and web-based applications. • Ability to operate standard office equipment, including fax machines, copiers, calculators, and mail-processing equipment. • Strong written and verbal communication skills, including the ability to read, write, type, and communicate effectively in English. • Excellent telephone communication and customer service skills, with the ability to handle inquiries professionally and respond to patient needs. • Strong organizational skills and attention to detail, with the ability to manage multiple referral requests and administrative priorities. • Critical-thinking and problem-solving abilities, particularly when reviewing admission processes, referral documentation, and insurance requirements. • Ability to interpret relevant government regulations, professional guidelines, technical procedures, and healthcare-related documentation. • Strong interpersonal skills and the ability to work collaboratively with patients, physicians, colleagues, and culturally diverse groups. • Ability to manage difficult or emotionally sensitive customer situations with patience, empathy, respect, and a non-judgmental approach. • High level of discretion and professionalism when handling confidential patient and organizational information. • Ability to adapt to changing priorities, work across departmental boundaries, and maintain a consistent focus on patient satisfaction. • Willingness to complete required orientation and training programs, as applicable.