Referral Specialist

• Handle incoming clinical tasks, phone calls, and in-person requests, reviewing clinical history and obtaining notes for provider when needed; ensuring correct payer, CPT, and ICD-10 codes are on referral requisition.
• All referrals are processed in a timely and efficient manner and according to the referral policies and procedures; insurance benefit and eligibility is confirmed prior to processing the referral, ensuring patient is assigned to a SH provider.
• Arrange appointments with external and internal specialties, faxing referral requisition and any pertinent information.
• Patients, or parent/legal guardian, are notified verbally regarding their appointment date, time, location, special instructions, and out-of-pocket expenses if applicable.
• Follow up on referrals pending prior authorization/appointment is done at least weekly, documenting all efforts made in EHR.
• Use of good time-management skills; contributing to increased productivity.
• Actively participating in staff meetings and working toward accomplishing department goals and objectives; ability to work well with team members. Accomplishing related results as needed.
• Statistics of all referrals processed are reported weekly to the Practice Manager.
• Use multiple software systems for insurance verifications and referral processing purposes.
• Demonstrates an understanding of organizational structure by utilization of appropriate channels of communication regarding all facets of departmental activities.
• Use of computers, fax/copy machines for the exclusive uses of clinic business; keeping work areas clean and organized at all times.
• Adhere to HIPAA confidential practices for patient information.
• Adhering to all Sunset Health policies and procedures.
• Performs other duties as assigned.

Preferred

• • Experience in handling personal, confidential information, appointment scheduling with extensive public contact experience preferred
  • Knowledge of AHCCCS and managed care plans

Required

• High School or better

Required

• Fingerprint Clear Card

Required

• Basic Computer Skills

Preferred

• Bilingual English/Spanish Preferred

Equal Opportunity Employer
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