Job Description
Job Description
ALBANY AREA PRIMARY HEALTH CARE, INC.
JOB DESCRIPTION
REFERRAL SPECIALIST
JOB SUMMARY
Works under the direction of the Chief Quality Officer and part of the Quality Department to ensure coordination between internal and external resources is handled appropriately to ensure quality of care to the patient.
This individual will act as the first contact for referring physicians’ offices and new patients related to the referral process.
JOB CLASSIFICATION : 109
DUTIES AND RESPONSIBILITIES
Daily, check the referral log from the previous day and maintain that log in a timely manner. Referrals should be completed within 30 days.
Call patients back with referral information promptly
Document the referral cycle in the appropriate location
Obtain authorizations as needed and required
Answer the phone and handle call appropriately
Resolves pre-certification, registration, and case-related concerns prior to a patient's appointment
Responsible for verifying and securing authorizations / referrals for all visits and coordinating all outside referrals, appointments, and authorizations for outside diagnostic testing and other services.
Responsible for scheduling, tracking, and communicating with patients to ensure completion of all physician referrals.
Provide timely feedback to provider if referral appointment is not kept
Ensure that documentation is received back into patient’s medical record for all diagnostic testing and outside referral services
This individual is responsible for expediting the administrative requirements for the patient referrals in the clinic, ensuring that appropriate referrals are made to participating providers;
with the patients' health plan