Referral and Authorizations Specialist at Tampa Family Health Centers – Tampa, Florida

Position Summary: In accordance with the Center’s policies and procedures, the referral Specialist functions under the direction of the referral Coordinator. This position is responsible for the planning implementation and follow-up of patient referrals generated by the primary care physician.

Essential Functions:

• Develops a comprehensive reference file of patient referral sources; serves as a resource person to other staff regarding the referral process

• Utilize physician orders and medical assistant or nursing skills to prioritize patient referral needs

• Schedule referral appointments timely

• Follows assigned rotation schedule to specific centers to process referrals; responsible for managing referrals at rotation sites to prevent back-log

• Initiates and assists in health education for patient and family

• All routine referrals to be initiated within 10 working days; ASAP referrals initiated within 3 working days; urgent referrals to be initiated within 24 hours; mail appropriate copy of referral to third party payer

• Thoroughly and accurately document referral efforts and outcomes; track referrals to ensure follow-up compliance

• Keep accurate, complete and current referral logs

• Collaborates with Case Managers and managed care providers to determine patient eligibility

• Identifies referrals to be schedule by other staff in accordance with the referral degree of difficulty

• Order referral forms from respective sources, as assigned

• Effectively utilize EHR to assist in the comprehensive scheduling and follow-up of referrals

• Alert appropriate care team members to challenges with referral funding

• Communication of referral status to physician, as appropriate

• Keep current in changes in managed care policies as related to the processing of referrals

• Collaborate with Medical Social Worker to identify and address financial assistance needs of patients to access specialty care

General Duties:

• Support the Mission, Vision and Values of Tampa Family Health Centers

• Performs clerical duties for Referral Service department including:

• Responds to calls in a timely manner

• Assists clinical team with urgent referrals as needed

• Assist internal and external customers with All referral needs

• Interact with clinicals staff

Knowledge and Experience:

• Strong communication skills, both oral and written

• Detailed -Oriented

• Ability to multi-task in a fast-paced environment

• Strong organization and prioritization skills

• Minimum (1) years’ referral experience

• Great work ethic

Education, Certification Training and License:

• High School graduate or equivalent

• Prefer experience with Microsoft applications

• Prefer previous medical front desk (verification/eligibility)