Referral Specialist

Summary

Performs clerical and operator duties of a confidential nature. Works independently receiving incoming/outgoing referrals from physicians’ offices, hospitals, and consumers through telephone, fax, and personal contact. Routes referrals to appropriate facility/staff for processing. Effectively communicates with providers, staff and visitors.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

Answering telephone calls from referral sources including physicians’ offices, hospitals, and patients, and collecting patient referral information sent by fax from referral sources.

Initiating outbound calls to physicians’ offices, hospital staff, or patients to obtain necessary information not included with the original referral request, and verifying any questionable data.

Maintaining referral records in an accessible, organized method to assure continuous work flow in the department. Assisting nursing staff with duties as needed.

Participates in CPI program. Maintains compliance, is knowledgeable, and utilizes the guidelines of all state and federal laws and regulations as they pertain to the position including, but not limited to; Health Insurance Portability Accountability Act (HIPAA), Scope of Practice, Accreditation Standards, Occupational Safety and Health Administration (OSHA), Bureau of Primary Health Care/ Health Resources and Services Administration (BPHC/HRSA), National Committee for Quality Assurance/Patient Centered Medical Home (NCQA-PCMH), Centers for Medicare and Medicaid Services (CMS), Clinical Laboratory Improvement Amendment (CLIA), Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and other HRSA related regulatory functions and/or agencies that Family Circle of Care participates in.

Patient Centered Responsibilities

Demonstrates ability to adjust to a varying workload and organize workload to maximize use of time without decrease in patient quality of care.

Participates in team huddles to promote clear communication amongst care team and providers.

Recording patient referral information in an established format, and forwarding the referral information to the appropriate clinic or to the admissions coordinators for processing.

Provides excellent customer service by utilizing good communication skills and technical knowledge to ensure that Family Circle of Care coordination of care and departmental objectives are maintained.

Supervisory Responsibilities

This job has no supervisory responsibilities.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; responds to requests for service and assistance; meets commitments.

Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.

Diversity - Shows respect and sensitivity for cultural differences.

Ethics - Treats people with respect; inspires the trust of others; works with integrity and principles; upholds organizational values.

Personal Appearance - Dresses appropriately for position; keeps self well groomed.

Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.

Safety and Security - Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly.

Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

High School Diploma or equivalent; knowledge of medical terminology preferred.

Computer Skills

To perform this job successfully, an individual should have knowledge of Microsoft Word Processing software, Microsoft Excel Spreadsheet software and Electronic Medical Record experience. EPIC experience preferred.

Certificates, Licenses, Registrations

LVN or related healthcare license preferred, but not required. No required certificates, licenses or registrations.

Physical Demands 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.

While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear. The employee is moderately required to stand; walk and reach with hands and arms. The employee is occasionally required to sit. The employee may occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee may be exposed to airborne particles, infectious disease, biohazardous waste, blood, and bodily fluids. Employee is required to follow all established blood born pathogen and hand washing procedures. The noise level in the work environment is moderate.