Referral and Authorizations Specialist

Tampa Family Health Centers•Tampa, FL

About The Position

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.

Requirements

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
High School graduate or equivalent

Nice To Haves

Prefer experience with Microsoft applications
Prefer previous medical front desk (verification/eligibility)

Responsibilities

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
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