Parkside Pediatrics - Referrals Specialist

Job Title: Referral Specialist
Division:Parkside Pediatrics
Weekly Hours: Part Time 20-29
Supervised by: Referral Coordinator, Parkside Pediatrics
Posting: Internal/External
Location: Remote
Position Overview: The Referral Specialist handles coordinating the referral process to provide high quality care for our patients. Ensuring that all involved providers, facilities, and patients have the information and resources needed to coordinate specialized care for the patient. Reviews clinical data to report medical necessity to insurance companies that lead to shared expectations for cost effectiveness. Supports the department members with shared tasks daily/weekly. These duties will require/range between 20-29 hours per week.
Responsibilities:

• Sends outgoing referrals and diagnostic imaging orders to specialist offices and receives incoming communication about those orders being processed.
• Ensures that patients are scheduled on time consistent with diagnosis and level of care needed and communicates appointment information with patient/family/caregiver.
• Follows up with specialist offices on pending referrals to gain consult notes/medical records and coordinates continuity of care with the provider as needed.
• Promotes excellent relationships between our practice and outside specialty offices.
• Serves all patients, families, caregivers, external specialty offices, community, and internal team members with grace and humility.
• Promotes an authentic and transparent work environment.

45%

• Initiating and facilitating the prior authorization process for imaging orders (CT/MRI/etc.).
• Responding to any telephone encounter requests for prior authorization and communicating with the ordering provider, as necessary.
• Communicating updates about Prior Authorizations with patients as necessary and returning phone calls from patients with questions about their prior authorization.
• Keeping track of how many Prior Authorizations are processed each week per division.

45%

• Communicating with Referrals Team Leads when experiencing down time and able to provide support to the referral specialists; aiding with various tasks including, but not limited to, sending outgoing referrals or DI orders, running reports for follow-up, and returning phone calls to patients.
• Handling out-of-state paperwork requests.
• May be needed to attend office meetings.
• Other duties as assigned.

10%
Required Minimum Education & Certifications:

• At least 6 months to 1 year of referral and authorization experience preferred.
• Expert computer skills and typing to include Microsoft Office Applications. i.e., Excel, Word, Teams, etc.
• Minimum education requirement: High School Diploma or GED.
• Home internet access required

Physical Requirements:

• Ability to sit at a computer terminal for extended periods of time.
• Ability to be physically in attendance at workstation at designated company office location during normal business hours chosen for this position.
• Ability to travel up to 10% of the time.
• Ability to lift, up to 20 lbs.

Tribe513 is an Equal Opportunity Employer