Health Referral Specialist at St. Josephs Candler – Savannah, Georgia
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About This Position
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Position Summary
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Serves as the central point of coordination for new patient intake, external referrals, transfers of care, and diagnostic services within the outpatient oncology clinic. This role ensures efficient scheduling, regulatory compliance, and continuity of care across care settings. Responsibilities include processing all incoming referrals by reviewing documentation for completeness and appropriateness, creating new patient charts, and collaborating with providers and clinical team to determine timely scheduling of initial appointments. The specialist communicates directly with patients to coordinate appointments and distribute new patient materials, while managing daily clinic schedules to align with provider volume standards. This position also oversees outgoing referrals and diagnostic orders, including preparation of required documentation and insurance information, scheduling of testing, and completion of necessary prior authorizations. Daily review of physician orders for external services is required to ensure accuracy and timely processing. In addition, the Health Referral Specialist maintains a working knowledge of clinic operations and provides cross-coverage support as needed. This role integrates strong customer service skills with telephonic and electronic communication tools to promote a seamless and positive patient experience.
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Education
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Associate's Degree or in lieu of a degree a minimum of 1 years of college - Preferred
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Experience
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2-3 Years Medical Office - Required
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1 Year Prior Authorization Management - Preferred
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License & Certification
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Professional Certification (CMA, PCT or CNA) - Preferred
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Core Job Functions
- Serves as the primary coordinator for new patient intake, external referrals, and transfers of care. Review and processes all incoming referrals to ensure completeness, appropriateness, and regulatory compliance. Creates and maintains accurate new patient charts in the electronic medical record (EMR).
- Monitors physician orders for patient referrals to diagnostic departments, specialists, and initiates referrals; facilitates with CBO the pre-certification process, contacts patients when necessary; provides feedback to providers as needed if delays occur, and maintains outstanding results list to assure patient compliance with physician orders.
- Assists to assure provider order entry and supportive care protocols are completed in a timely manner to meet patient expectations, clinical team needs, scheduling, and billing.
- Refers patients to correct laboratory, imaging center, hospital or specialist. Ensures precertification is obtained when needed prior to services being rendered. Follows referral process based upon insurance company's policies and procedures. Notify patients of any delays in approval or whenever necessary.
- Manages insurance pre-certifications and authorizations as needed for referrals or diagnostics. Provides timely follow up on all inquiries and requests regarding authorization issues.
- Provides clerical support to the office. Answer phones, complete patient requests, and route calls appropriately.
- Assist in the coordination of care as directed by office team leads or practice administrator. Including providing coverage for office staff (i.e. switchboard front desk-office coordinators) as requested.