Referral Specialist is responsible for coordinating and processing of referrals, pre-certifications, and authorizations for internal and external referrals for health center patients with the objective of ensuring timely, streamlined and efficient referral practices. Acts as a resource for teams, staff, and patients by maintaining current knowledge of insurance requirements and communication of those requirements to teams staff and patients.
RESPONSIBILITIES INCLUDE:
- Responsible for coordination, implementation, generation and authorization of referrals to outside providers, specialists and other agencies with attention to patients insurance.
- Obtains appropriate authorizations from insurance company and documents authorization on referral and in EMR.
- Responsible for directing progress notes, labs, and xrays to specialists as required for completing referral.
- Review details and expectations about the referral with patients.
- Serves as point of contact and resource to patients, team and staff.
- Process and call all stat referrals for team.
- Responsible for documentation of all processed referrals in EMR.
- Serve as a phone liason for patients outside providers, specialists and other agencies regarding referrals.
- Ensures that all referrals are done accurately and within a timely manner
