Referral Specialist

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.

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• • Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver’s license.

1.  Greets all patients, whether in person or via the telephone, with a cheerful and helpful attitude.
2.  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.
3. Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing.
4.  Refers self-pay and out-of-network patients to the appropriate resource to help with payment.
5.  Complete pre-certification/authorization with the patient’s insurance company providing any necessary documentation.
6.  Document authorization/pre-certification once received along with contact information of the person spoken with.
7.  Contacts the patient and notifies them of the scheduled procedure and all necessary instructions.
8.  Coordinates with the hospital or facility the arrival times of each scheduled patient and contacts them with this information.
9.  Assists in reviewing and revising policies and procedures pertaining to scheduling function.
10. Performs other responsibilities as necessary to ensure efficiency within the practice.
11. Maintains operational knowledge of department equipment: telephones, computers, faxes, copier, printers, etc.
Age Specific Care:
Provides age and culturally appropriate assessment, interpretation of clinical and laboratory data and develops and implements age appropriate interventions and plans of care including education within the parameters of his/her position responsibilities and licensure. Ensure staff considers age related concerns such as: hearing, vision, speech and level of understanding, when interacting with patients, employees and families.

The posted pay range is a good faith representation of potential base pay for this position. It may be modified in the future and eligible for additional pay components. Individual annual salaries/hourly rates could vary based on position details and FTE. Pay is determined by considering factors including, but not limited to, experience, relevant qualifications, specialty, internal equity, locations, and contracts.