Referral Specialist at Premier Community Healthcare Grp. – Dade City, Florida

Join the Premier Team – Where Passion Meets Purpose!

Premier Community HealthCare is a nonprofit Federally Qualified Health Center (FQHC) dedicated to serving Pasco and Hernando Counties. We offer a wide range of high-quality services, including Family Medicine, Pediatrics, Women’s Health, Dental, Behavioral Health, and more. Our team is focused on improving access to healthcare services and providing high quality and compassionate care to our community.

Premier Community HealthCare is seeking a Full-Time Referral Specialist to join our team. As a key member of our patient services team, you will be responsible for managing referrals, coordinating care with specialists, and ensuring that patients receive the appropriate services in a timely manner. If you're passionate about delivering exceptional healthcare services and enjoy working in a fast-paced environment, we invite you to apply!

? Why Choose Premier?

• Full-Time Position – Enjoy a stable and predictable work schedule
• Impactful Work – Help ensure patients receive the referrals they need to access specialized care
• Supportive Environment – Be part of a mission-driven organization focused on providing high-quality care
• Growth Opportunities – Opportunities to grow and advance your career with Premier

Join us and help make a difference in the lives of our patients every day!

Summary: Obtains verification and authorization for treatment as Primary Care Physician (PCP) deems necessary for continued patient care.

PROFESSIONAL KNOWLEDGE, SKILLS AND ABILITES:

• High School Diploma or GED.
• Basic understanding of medical terminology and documentation.
• Ability to use basic mathematical skills.
• Able to perform repetitive tasks.
  

ESSENTIAL DUTIES AND RESPONSIBILITIES: includes the following, other duties may be assigned.

• Assures all referrals are handled effectively and efficiently.
• Work priorities are set in order to accomplish tasks received by providers.

• Notify provider of any barriers to processing the referrals.

• Communicate with patients’ referral process and progress.
• Generate Referral.
• Contact insurance carrier for provider appropriate for patients' insurance.
• Obtain clinical notes, labs images etc.
• Enter referral information into current practice management system.
• Fax referral and clinical documentation to provider office prior to appointment.
• Informs patients of their referral responsibilities.
• Request authorization.
• Process authorization request through insurance websites.
• Forward to specialty provider.
• Scan all documentation into patient's chart.
• Close referral.
• Close referrals that have expired
• Follow-up on pending referrals to include sending letters to non-compliant patients.

• Ensure patient confidentiality and EMR security at all times.
• Maintain patient information within HIPAA guidelines.

• Keep other care team members informed when situations occur that disrupts timely patient flow through site.
• Consistently participates in and actively adheres to patient care expectations to attain clinical goals set forth in the PCHG Health Care Plans and the Quality Improvement / Quality Assurance (QI/QA)
  

SUPERVISORY RESPONSIBILITIES: None

GENERAL DEVELOPMENT:

• Maintains a professional relationship and positive attitude with co-workers, the public, patients and the entire organization.
• Maintains the highest professional and work ethics.
• Displays enthusiasm toward the work, mission and vision of the organization.

COMMUNICATIONS SKILLS:

1. Exceptional Customer Service skills.
2. Ability to communicate effectively, verbally and in writing.
3. Excellent grammar, spelling and interpersonal skills.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Ability to lift 20 lbs. regularly and 30 lbs.-50 lbs. occasionally.
2. Ability to sit for long periods of time.
3. Direct exposure to computer screen.
4. May be exposed to contagious/infectious diseases.