Referral Specialist

POSITION: Referral Specialist

DEPARTMENT:  Compliance

REPORTS TO:  Health Information Manager

DIRECT REPORTS: None                                       

FLSA STATUS: Non-Exempt

CORE VALUES

The core values of Community Health Center of Southeast Kansas, Inc. (CHC/SEK) are dignity and stewardship.  Each staff member is expected to perform their job duties in a way that preserves dignity for our patients and maintains good stewardship of CHC/SEK’s resources.

GENERAL DESCRIPTION OF POSITION

This position is part of the health information team providing support to patients and healthcare providers throughout the organization. The Referral Specialist is responsible for ensuring that referrals to external providers are completed in a courteous, efficient, accurate, and timely manner with appropriate documentation to help ensure continuity of care for patients and referring providers. The Referral Specialist also reviews files, records, and other documents to obtain information in order to respond to requests and communicates with patients, staff, and others to disseminate or explain the referral process and provide overall guidance in the process.

ESSENTIAL DUTIES

  1. Schedules and confirms patient diagnostic appointments, surgeries and consultations.
  2. Accurately documents referrals within the Electronic Health Record.
  3. Performs authorizations and pre-certifications by completing and submitting documents and discussing requirements with providers, insurance carriers and patients.
  4. Tracks referrals to assure documentation is obtained to assure continuity of care.
  5. Schedules follow-up appointments and works with consulting providers and patients to assure that appointments are kept.
  6. Requests patient health information from other entities.
  7. Understands and is able to perform health information functions such as accurately and efficiently scanning documents into the Electronic Health Record.
  8. Performs other duties as assigned.

QUALIFICATIONS

  1. High school diploma or equivalent.
  2. Familiarly with medical terminology.
  3. Experience in healthcare setting preferred.

KNOWLEDGE, SKILLS AND ABILITIES

  1. Ability to communicate in a professional, courteous and respectful when interacting with staff, external organizations, patients and family members.
  2. Familiarity with healthcare – especially medical - terminology
  3. Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base.
  4. Must be organized and able to manage/prioritize tasks to meet deadlines, adapts to change in a positive manner, able to work as a part of a team.
  5. Communicates through appropriate channels. Use proper chain of command for complaints.
  6. Must be computer literate, especially with Microsoft Office products and be proficient with the Electronic Health Record software.
  7. Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team.
  8. Provide customer service in accordance to the organization’s mission.
  9. Maintain patient confidentiality in accordance to organization’s policy and procedure and HIPAA requirements.

WORKING CONDITIONS

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand and walk.  The employee must regularly lift and /or move up to 10 pounds.  Specific vision abilities required by this job include close vision and peripheral vision. The noise level in the work environment is usually moderate.

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