Referral Representative

at  Franciscan Missionaries of Our Lady Health System

Primarily responsible for processing referrals from practice providers to specialists, hospitals and diagnostic centers ensuring that the facility and insurance provider requirements are met to ensure patients obtain required services in the appropriate setting. Also responsible for accurately validating patient information, verification of insurance coverage, and ensuring the patient’s experience is best in class.

• Patient Access - Referrals Processes
• Accurately and efficiently processes referrals to specialists, hospitals and diagnostic centers in accordance with physician orders processing referrals in a timely manner for required services in the most appropriate setting; coordinates the referrals with insurance providers so that financial liability to the patient is minimized.
• Works closely with physicians, nurse practitioners and nursing staff to ensure that referrals to other providers/services/facilities are completed in accordance with payor requirements in a timely manner.
• Obtains/scans outside clinic records after appointment to assure continuity of care.
• Clinic Operations & Patient Flow
• Actively supports clinic, practice, hospital and health system initiative related to improvement in the day-to-day operations.
• Assists patients with access to government and community resources to enhance their access to health care services.
• Performance Excellence
• Actively supports the organizations performance excellence initiatives including Lean Six Sigma.
• Performs duties in a manner that results in improved patient outcomes and patient satisfaction.
• Actively supports the organizations Culture of Excellence utilizing initiative to make suggestions that would improve the patient’s experience and the environment of care.
• Other Duties as Assigned
• Performs other duties as assigned or requested.
• Provides quality training and orientation for assigned employees.

Education - High School or equivalent
Special Skills - Strong organizational skills; professional demeanor, excellent customer service skills, ability to multi-task, critical thinking, demonstrated computer literacy, ability to learn and demonstrate proficiency in Epic during the introductory period.

• Patient Access - Referrals Processes
• Accurately and efficiently processes referrals to specialists, hospitals and diagnostic centers in accordance with physician orders processing referrals in a timely manner for required services in the most appropriate setting; coordinates the referrals with insurance providers so that financial liability to the patient is minimized.
• Works closely with physicians, nurse practitioners and nursing staff to ensure that referrals to other providers/services/facilities are completed in accordance with payor requirements in a timely manner.
• Obtains/scans outside clinic records after appointment to assure continuity of care.
• Clinic Operations & Patient Flow
• Actively supports clinic, practice, hospital and health system initiative related to improvement in the day-to-day operations.
• Assists patients with access to government and community resources to enhance their access to health care services.
• Performance Excellence
• Actively supports the organizations performance excellence initiatives including Lean Six Sigma.
• Performs duties in a manner that results in improved patient outcomes and patient satisfaction.
• Actively supports the organizations Culture of Excellence utilizing initiative to make suggestions that would improve the patient’s experience and the environment of care.
• Other Duties as Assigned
• Performs other duties as assigned or requested.
• Provides quality training and orientation for assigned employees