Referral and Authorizations Specialist

Position Summary: 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.

Essential Functions:

• 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

General Duties:

• 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

Knowledge and Experience:

• 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

Education, Certification Training and License:

• High School graduate or equivalent
• Prefer experience with Microsoft applications
• Prefer previous medical front desk (verification/eligibility)