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Referral Specialist- Flaget

CHI Saint Joseph Medical Group Bardstown, Kentucky
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Requisition ID 2022-234426 Employment Type Full Time Department General Medical Clinic Hours/Pay Period 80 Shift Day Weekly Schedule 7:30am-6:00pm ; Monday-Thursday Remote No Category Billing and Scheduling
Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.


Responsibilities

The Referral Specialist works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits.  Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

Expectations: 

  • Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.
  • Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter service, specialty care, etc.
  • Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.
  • Enter referrals, documents communications and action into the system, as appropriate.
  • Notify physician(s) and patient when referral is denied, or if additional information is needed.
  • Develop and maintain database of referral physician offices preferred by each physician within the clinic.
  • Assist Practice Manager with complaint resolution and solutions related to patient referrals.
  • Preform other duties as assigned by the Practice Manager or Physician.

Qualifications

Required Education for Staff Job Levels

  • High school diploma or equivalent.

Required Minimum Knowledge, Skills and Abilities

  • Knowledge of clinic referral and scheduling processes and billing/authorization requirements. 
  • Knowledge of federal and state pay requirements, including Medicare. DSHS, HMO/PPO contracts.
  • Ability to communicate effectively and to maintain strict confidentiality. 
  • Ability to respond to people and issues promptly and appropriately, to resolve problems. 
  • A team player who handles multiple projects simultaneously in a fast-paced environment. 
  • Possess a strong work ethic and a high level of professionalism.

PREFERRED Qualifications

  • Healthcare experience preferred.
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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.