Referral Specialist (Full-time, Days) in ROCHESTER, New York at Rochester Regional Health

Summary

This position is responsible for scheduling and obtaining authorization/pre-certifications for, but not limited to MRI, CT, Neurology, Pain Management and other specialized testing as well as referrals to other MD Specialists and for detailing all patient and third-party interaction in the patient’s EMR. Promotes and provides customer satisfaction and appropriateness of care for all assigned patients.

Job Title: Referral Specialist

Department: Reidman Campus

Location: 100 Kings Highway South Rochester, NY 14617

Hours Per Week: 40 - Full-time

Schedule: Monday-Friday, 8am-430pm

Responsibilities

• Greets all patients, whether in person or via the telephone, with a cheerful and helpful attitude.

• Provides coordination of testing to be performed with physician, patient, facility and payer. This includes reviewing medical documents for clarity, ensuring all necessary clinical steps have been taken; works with necessary parties to obtain third-party approval.

• Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing.

• Refers self-pay and out-of-network patients to the appropriate resource to help with payment.

• Complete pre-certification/authorization with the patient’s insurance company providing any necessary documentation.

• Document authorization/pre-certification once received along with contact information of the person spoken with.

• Contacts the patient and notifies them of the scheduled procedure and all necessary instructions.

• Coordinates with the hospital or facility the arrival times of each scheduled patient and contacts them with this information.

• Assists in reviewing and revising policies and procedures pertaining to scheduling function.

• Performs other responsibilities as necessary to ensure efficiency within the practice.

• Maintains operational knowledge of department equipment: telephones, computers, faxes, copier, printers, etc.

Required Qualifications:

• High school diploma or GED required.

Preferred Qualifications

• Associate of Applied Science (AAS) degree or related field.

• Knowledge of medical terminology.

• Knowledge of orthopedic terminology (highly preferred).

• Previous healthcare, medical office, scheduling, registration, or patient access experience.

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE: $19.00 - $24.00

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, clinical licensure date, relevant qualifications, specialty, internal equity, location, and contracts.