Job Title: Referral Specialist
Department or Practice: Community Health Center
Location: Great Barrington, MA- Location is flexible
Level/Salary Range: Commensurate with exeperience
Position Type: Full-time, benefits eligible
Community Health Programs seeks a Referral Specialist to join our primary care practice located in the heart of the Berkshires. The Referral Specialist coordinates patient care assistance services with various external organizations; manages referrals to specialty providers as directed by the primary care providers in the Health Center including appointment arrangements, transportation and translation services; manages relationship between patient and health center with various insurance companies to insure compliance with referral authorization requirements; assists Coordinator in developing and managing electronic referral system in the EMR; performs other administrative duties as requested.
The Referral Specialist contributes to a work environment that is caring, collaborative, and innovative. This person will support CHP’s mission, vision, and values and will adhere to compliance protocols as well as CHP’s policies and procedures.
|Essential Duties and Responsibilities: other duties may be assigned|
- Coordinates all outgoing/incoming referrals and prior authorizations; maintains the computerized managed care system and maintains Electronic referrals in EMR; schedules all referral appointments and documents this information on the referral request form and practice management system and notifies patient of same.
- Collaborates with the primary care provider to resolve issues related to specialist availability and patient needs; sends all completed referral forms to the Medical Records department for filing in the patient’s chart; maintains a system for easy access to authorization numbers, number of visits and utilization
- Completes follow-up with hospitals with regard to submitting orders and any other related documentation (financial or clinical); functions as a resource of information and problem solving for patients, primary care providers managed care program staff, specialists and Health Center staff; maintains up-to-date knowledge of insurance company requirements; assists with development and presentation of managed care reporting to Coordinator on monthly basis, including but not limited to, indicating numbers of referrals, turnaround time for booking referrals and utilization
|Education and/or Experience:|
A high school diploma or equivalent is required. College graduate preferred. Electronic medical records experience is preferred.
|Competencies: To perform the job successfully, an individual should demonstrate the following competencies|
- Ability to interact with others with tact and diplomacy; treat others with respect and consideration regardless of status or position; contribute to a positive team spirit; balance team and individual responsibilities; display highest degree of professionalism and ethics
- Respond appropriately to patient needs; manage difficult or emotional patient situations in a way that instills trust and respect; solicit feedback to improve performance
- Ability to manage multiple priorities; work well under pressure; complete tasks correctly and on time with limited supervision; step in when needed and cross train for additional site coverage; respond promptly to requests for service and assistance
- Ability to effectively present information in one-on-one or small group situations; respond well to questions; complete administrative duties accurately and timely
- Ability to calculate figures and amounts; solve practical problems; interpret a variety of instructions furnished in written, oral, diagram or schedule form
- Punctual and reliable; ability to maintain schedule commitments
- Spanish speaking/bilingual is a plus
To apply for this position, please submit each of the following:
– Cover Letter
|Applications accepted by:
Kelly Krok, Director, Human Resources
Community Health Programs, Inc.
444 Stockbridge Rd. / P.O. Box 30
Great Barrington, MA 01230