Referral Specialist at Premier Community Healthcare Grp.

Dade City, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

18 Jan, 26

Salary

0.0

Posted On

20 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Terminology, Documentation, Mathematical Skills, Customer Service, Communication, Patient Confidentiality, HIPAA Compliance, Referral Management, Authorization Processing, Team Collaboration, Problem Solving, Attention to Detail, Time Management, Professional Ethics, Interpersonal Skills

Industry

Description

Join the Premier Team – Where Passion Meets Purpose! Premier Community HealthCare is a nonprofit Federally Qualified Health Center (FQHC) dedicated to serving Pasco and Hernando Counties. We offer a wide range of high-quality services, including Family Medicine, Pediatrics, Women’s Health, Dental, Behavioral Health, and more. Our team is focused on improving access to healthcare services and providing high-quality and compassionate care to our community. We’re looking for a Full-Time Referral Specialist to join our team in Dade City, Florida! In this role, you’ll help connect patients with the care they need, supporting our mission to make healthcare more accessible to the community. ✅ Why Join Premier? * Full-time schedule with benefits * Team-focused, mission-driven work environment * Make a real impact on patient care and community health Join us and make a meaningful impact on our organization and community! Summary: Obtains verification and authorization for treatment as Primary Care Physician (PCP) deems necessary for continued patient care. PROFESSIONAL KNOWLEDGE, SKILLS AND ABILITES: * High School Diploma or GED. * Basic understanding of medical terminology and documentation. * Ability to use basic mathematical skills. * Able to perform repetitive tasks. ESSENTIAL DUTIES AND RESPONSIBILITIES: includes the following, other duties may be assigned. * Assures all referrals are handled effectively and efficiently. * Work priorities are set in order to accomplish tasks received by providers. * Notify provider of any barriers to processing the referrals. * Communicate with patients’ referral process and progress. * Generate Referral. * Contact insurance carrier for provider appropriate for patients insurance. * Obtain clinical notes, labs images etc. * Enter referral information into current practice management system. * Fax referral and clinical documentation to provider office prior to appointment. * Informs patients of their referral responsibilities. * Request authorization. * Process authorization request through insurance websites. * Forward to specialty provider. * Scan all documentation into patients chart. * Close referral. * Close referrals that have expired * Follow-up on pending referrals to include sending letters to non-compliant patients. * Ensure patient confidentiality and EMR security at all times. * Maintain patient information within HIPAA guidelines. * Keep other care team members informed when situations occur that disrupts timely patient flow through site. * Consistently participates in and actively adheres to patient care expectations to attain clinical goals set forth in the PCHG Health Care Plans and the Quality Improvement / Quality Assurance (QI/QA) SUPERVISORY RESPONSIBILITIES: None GENERAL DEVELOPMENT: * Maintains a professional relationship and positive attitude with co-workers, the public, patients and the entire organization. * Maintains the highest professional and work ethics. * Displays enthusiasm toward the work, mission and vision of the organization. COMMUNICATIONS SKILLS: 1. Exceptional Customer Service skills. 2. Ability to communicate effectively, verbally and in writing. 3. Excellent grammar, spelling and interpersonal skills. WORKING CONDITIONS AND PHYSICAL REQUIREMENTS: 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. 1. Ability to lift 20 lbs. regularly and 30 lbs.-50 lbs. occasionally. 2. Ability to sit for long periods of time. 3. Direct exposure to computer screen. 4. May be exposed to contagious/infectious diseases. This job description in no way states or implies that these are the only duties to be performed by the employee(s) serving in this position. Employee(s) will be required to follow any other job-related instructions and to perform any job-related duties requested by any person authorized to give instructions or assignments.

Responsibilities

The Referral Specialist obtains verification and authorization for treatment as deemed necessary by the Primary Care Physician. They ensure all referrals are handled effectively and efficiently while maintaining patient confidentiality and EMR security.