Referral Specialist
Core
Review, analyze, and document referral requests; obtain authorizations for managed care, Medicaid, and Medicare plans; coordinate scheduling of specialty care for patients.
Role type
Referral Specialist (Healthcare Operations)
Builds
Patient referral workflows and appointment scheduling for specialty care
Domain
Healthcare administration / Insurance authorization
Required skills
PC skills, customer service, organizational skills, communication, Epic system proficiency, telephone communication, data analysis, documentation, resource management
Responsibilities
Access and analyze daily referral queues to prioritize work; research referrals to verify documentation and obtain necessary authorizations; communicate with specialty offices and patients to arrange appointments; document appointment information for primary care offices; maintain desktop reference information for assigned specialties; answer patient calls to match physicians based on geography, insurance, and medical needs; monitor referral queue aging to report on patient care accessibility.
Seniority
Mid-level individual contributor