Healthy Rural Communities. Healthcare Revolutionized.
Referral Specialist
Location
Oregon
Posted
1 day ago
Salary
$20 - $22 / hour
Seniority
Junior
Job Description
Referral Specialist
Orchid Health
• Ensure appropriate appointments and follow-up appointments in the clinic following referral requests/visits. • Ensure documentation from specialists/offices is obtained, filed in the chart and forwarded to companies/payers as appropriate. • Perform patient registration tasks and procedures as requested as well as assist in the clinical area as trained and requested. • Initiate all referral requests within 24-48 hours on business days. • Return all calls promptly generally within the same day. • Document all stages of the referral process within the EMR program (Athena) and communicate to the appropriate people regarding injury cases. • Coordinate and schedule specialty exams within the clinic as necessary. • Obtain and/or document approvals from Third-Party Payers for payment for services as directed or indicated via protocols. • Answer phone calls and act as a liaison between companies, patients, attorneys and work comp insurance companies. • Request any missing documentation from providers, once received and signed off by the medical director, scan appropriate information into the EMR program (Athena). • Resolves pre-certification, registration and case-related concerns prior to a patient's appointment. • Gather pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided. • Use the EHR (Athena) to monitor referral orders and document all referral activities in the EHR. • Complete prior authorizations when needed. • Complete appropriate referral forms. • Consult with providers regarding specific diagnosis information, as it relates to the referral. • Comply with federal, state and local regulations regarding patient confidentiality and HIPAA. • Ensure that the patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. • Perform other job-related duties, as may be assigned.
Job Requirements
- High school diploma or GED certificate.
- Minimum of 1 year relevant healthcare experience.
- Proficient at Excel, Word, and Outlook.
- Excellent communication and problem-solving skills.
- Excellent interpersonal skills, empathy and tact, when dealing with insurance companies, patients and other health care facilities.
- Able to assume the responsibilities delegated by the Manager, to provide efficient and effective coordination of care.
- Willing to adapt to changing situations and circumstances.
- Preferred Qualifications: Bilingual in Spanish. Athena experience. Knowledge of medical terminology
Benefits
- Medical, Dental, & Vision – Orchid pays monthly premiums at 100% for team members and at least 50% for their dependents for base medical and dental plans
- $1,000/year Wellness Benefit - for things that make you happy!
- 401(k) with a company match and financial planning and wellness resources available at no cost.
- A Continuing Education / Continuing Medical Education budget for all team members
- An Employee Assistance Program (EAP) that provides mental health support, financial planning, and lifestyle training opportunities, at no cost to employees
- 128 hours of PTO per year, annually front-loaded with tenure-based increases
- 40 hours of paid inclement weather and emergency closure leave, annually front-loaded
- 8 paid holidays, plus your birthday off!
- Free care at our clinics for team members and their families
- And more!
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