Referral Specialist Family Medicine
Job Description
Primary City/State:
Phoenix, ArizonaDepartment Name:
Admin-ClinicWork Shift:
DayJob Category:
Administrative ServicesGreat careers are built at Banner Health. We understand that talented health care professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices throughout our network of facilities. Apply today, this could be the perfect opportunity for you.
Banner Health Greenway Family Medicine physicians provide centralized care for patients and their families over the course of their lifetime. They work with patients of all ages and provide primary physician services. Our staff and providers form deep and meaningful partnerships with their patients by delivering important preventative care, helping patients manage conditions or offering support and guidance when health symptoms arise.
As a Referral Specialist on this team, we offer a customer-focused and friendly work environment with career growth opportunities. You'll have the opportunity to work directly with patients and with an engaged group of physicians and staff. A career with our team is great if you are just starting out or have many years of experience. If you are ready to be challenged, work in a positive environment and contribute to making a change in people's lives, then we are the perfect team for you.
Location: 4720 E. Greenway Rd Phoenix, AZ 85032
Schedule: Monday-Friday 8-hour shifts between the hours of 7:00am-5:00pm
POSITION SUMMARY
This position is responsible for coordinating referral orders for a continuation of treatment, such as specialty services and diagnostic testing within a primary care practice. This position provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered. The position is responsible for tracking and managing all referrals with the intention and outcome to close any patient care gaps, along with providing documentation to promote team awareness.
CORE FUNCTIONS
1. Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
2. Acts as a liaison between patients, providers and staff members for patients’ referral and follow up needs. Provides prompt and professional service for the patients by assisting in educating patient/family and assisting patients with external resources when needed.
3. Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered by verifying coverage, obtaining authorization and communicating with receiving facilities
4. Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals and following up with patients if appointments are not kept
5. Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment. Utilizes internal and external resources to seek knowledge about regulations regarding various payor sources
6. Collaborates with outside referral sources and other community resources. Maintains an updated list of community resources and networks with colleagues to develop additional referral sources
7. This position has frequent communications with patients, physicians, staff, and third party payers. The position must work with and understand the concepts of managed health care and be able to prioritize tasks within established guidelines with moderate supervision
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.
Possesses 1 year of direct patient interaction/experience in a medical, insurance, or healthcare related industry.
Knowledge of HIPAA regulations. Strong customer service focus and willingness to problem solve. Effective verbal and written communication skills and the ability to manage competing priorities. Must be proficient with commonly used office software.
PREFERRED QUALIFICATIONS
Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9 and CPT codes.
Additional related education and/or experience preferred.
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