Referral Specialist Job Description
Referral specialist
provides internal/external customer service including needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Referral Specialist Duties & Responsibilities
To write an effective referral specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included referral specialist job description templates that you can modify and use.
Sample responsibilities for this position include:
Investigating problems identified by community physicians, which requires considerable investigation initiative, and discretion
Resolving problems or referring information or recommendations to the Supervisor
Contribute to and provide inputs to annual work plan, required project reports, baseline data, tools and indicators for monitoring and evaluation, collection / sharing of lessons learned
Serve as a Duke medicine Ambassador by providing a comprehensive access experience including helpful resources, information, and accurate answers to questions
Foster a partnership to encourage trust, respect, and communication
Communicate via the RELATE communication model, work for a resolution, own service recovery, and use communication skills to build trust
Express appreciation and adapt behavior and communiciation styles to meet the individual's needs
Provide accurate business data collection using the Customer Relationship Management software (eCentaurus) in addition to Maestro Care
Follow all defined call protocols, scripts, eCentaurus searches, and other constructive research in responding to the customers's needs, providing problem solving and developing alternatives and options
Assumes ownership of each customer interaction and when appropriate, transfers caller too their identified Duke Medicine area with a partnership approach
Referral Specialist Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Referral Specialist
List any licenses or certifications required by the position: BLS, CPR, ASCP, MT, MDS, GSA, MA
Education for Referral Specialist
Typically a job would require a certain level of education.
Employers hiring for the referral specialist job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Education, Associates, Healthcare, Health, Business, Social Work, Nursing, Psychology, Health Care, Medical
Skills for Referral Specialist
Desired skills for referral specialist include:
Medical terminology
Any combination of education and experience which would provide an equivalent background
Insurance providers
Their portals and their expectations for authorization approval
Phone and filing systems
Basic Medical Terminology
ICD/CPT
Meeting quality standards for delivered services and evaluation of customer satisfaction
Principles and processes for providing effective customer service
Clinic referral and scheduling processes and billing/authorization requirements
Desired experience for referral specialist includes:
Communicates new information learned related to Duke Medicine clinical services and providers to Service Access Managers for validation and distribution to DCRC team
Register new patients at the time of their appointment request
Determine most appropriate provider, services and location for appointment based on scheduling guidelines, provider preferences and patient/referring provider preferences through the use of scheduling questionnaires
Rescheuule patient or provider-initiated cancellations or reschedules, when appropriate
Request outside records and imaging based on department guidelines
Communicate details information and answers patients’ questions regarding their health care plan
Referral Specialist Examples
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Referral Specialist Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of referral specialist. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for referral specialist
- Serve as initial contact and coordinator for International patients, specialty care service line and other specialty clinics
- Coordinate all necessary appointments and follow-up procedures while focusing on excellent patient relations and ensuring compliance with Physician discharge orders
- Maximize the use of UMMC/UMP physicians as referral sources
- Coordinate patient follow-up care schedule in a way that ensures patients receive timely patient care and is sensitive to the need for multiple return visits
- Handle all communications and case related inquiries due to provider or employer referral on a daily basis
- Keep report of all referral line cases (opened, active or in progress, closed) by a provider or employer
- Coordinates necessary logistics and follows up with internal Swedish appointed individuals, providers, local health authorities, port agents, and vendors to ensure appropriate referral services delivery to all clients (providers and employers)
- Handles all referral services and follows up with involved participants, providers or employers
- Educate involved parties of the referral service program process
- Keep electronic updated copies of all templates and client protocols for the referral service program
Qualifications for referral specialist
- Must have 1-2 years of prior Call Center experience
- Strong knowledge of electronic medical records and scheduling systems
- Excellent phone management and organizational skills
- Proven problem solving, organizational and decision making skills
- 2 or greater years of medical office or related administrative experience
- Knowledge of the registration and authorization process
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Referral Specialist Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of referral specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for referral specialist
- Systematically contact referral sources and qualified prospects based on a segmented, prioritized quarterly market growth plan and key customer target accounts, developing relationships to generate repeat referrals
- Work closely with program management, all operational staff, and in particular Intake staff to develop and maintain a database of qualified prospects, referrals and enrollments, including demographic and customer profile data
- Nurture the loyalty of referral sources and relationships with qualified prospects
- Act as Liaison between contracted providers (ALF & AFH) & ElderPlace to problem solve & improve communication and processes
- Technical understanding of moderate and high complexity testing as defined by CLIA and CMS
- Act as primary point of contact in answering internal and external customers’ technical questions
- Responsible for reviewing all miscellaneous and kit test orders systemwide, and speaking with physicians and clients, as appropriate
- Data driven and strong research and analytical skills in conducting test comparisons by performing lab
- Proficient in Microsoft Office suite products, including Excel and Powerpoint
- Ability to consistently and successfully multi-task and re-prioritize tasks to meet established timeframes
Qualifications for referral specialist
- Ability to utilize multiple modes of communication
- Some post high school education in service or medical access related area
- Bachelor’s Degree (BA) in healthcare associated field
- 1 year previous office experience in a medical setting, preferred
- Basic knowledge of computers and office equipment
- High School Student from an accredited institution,age 17 or older, college student or GED
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Referral Specialist Job Description
Job Description Example
Our company is looking for a referral specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for referral specialist
- Providing excellent customer service to all customers - patients and their family members, providers, office staff, internal departments, and insurance company employees
- Obtaining appointments with Non-OSF specialty providers or facilities
- Determining the pertinent clinical information in the patient's EMR to send to the Non-OSF specialist
- Researching specialists and facilities In Network with various insurance payors and plans
- Organizing and updating provider and facility demographics and referral requirements, insurance payor and plan specifications, Referral Center processes and policies information pertaining to assigned workqueues
- Effectively utilizes resources/databases to respond to callers requests for Health Center, specialty clinic, UM provider, or general Health System information, community-based alternative resources
- Works collaboratively with Coding, Provider Enrollment, and Cash Posting team coworkers, Team Leads, Managers, and practice staff to resolve claim and account issues
- Ensures confidentiality of patient and institutional information
- Monitors patient needs and responds to inquiries
- Responds to third party payers, employers, internal staff, and physician questions
Qualifications for referral specialist
- Knowledge and understanding of financial and medical insurance information
- 1 year experience in healthcare environment preferred or any combination of education and experience, which would provide an equivalent background
- Prefer candidates with medical background CNA, medical insurance or doctor’s office experience with the Call Center experience
- 1-3 years of experience in a healthcare environment required
- High School Student age 17 or older, college student or GED
- The physical requirements of this position are light work - exerting up to 25 lbs
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Referral Specialist Job Description
Job Description Example
Our innovative and growing company is looking for a referral specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for referral specialist
- Follows established policies and procedures in performing job functions
- Assist students in locating and arranging for medical specialist or mental health referrals
- Advise students with other than the school insurance on how to coordinate their benefits to minimize expenses with their private insurance carrier, particularly students with HMO plans
- Correspond with school insurance plan account representatives, IT and Customer Service Supervisor on website issues, plan content, customer service and claims issues
- Cover various campus events such as Graduate Student Orientation, TRUE & GRO meetings to provide infromation on Student Health Benefit Pan
- Provide training as appropriate to new and current staff regarding referrals, insurance, and policy issues
- Meetings with the CC clinical case manager, the SHWC insurance & referral coordinator, and the directors of graduate student academic affairs
- Serve on Student Health Insurance Committee and attend meetings for post-implementation, renewal and pre-renewal of student health insurance plan for JHU, serve on Student Insurance Policies Committee Student Insurance FAQ Committee
- Set up appointments, coordinate clinic visits, and any special arrangements
- Responds to third party payors, employers, internal staff, and physician questions
Qualifications for referral specialist
- Must have current driver’s license and automobile available for daily use and out of town travel with proof of liability insurance
- Associate degree or equivalent combination of education and experience in the healthcare industry
- Degree in relevant discipline or equivalent skills, knowledge and experience ideally gained within a government agency, industry specific body or ombudsman
- Ability to manage a range of competing deadlines and complex issues
- Super analytical and oral written communication skills
- Knowledge of legislation and regulations, issues and contemporary practices relevant to complaints management and associated systems
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Referral Specialist Job Description
Job Description Example
Our company is growing rapidly and is looking for a referral specialist. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for referral specialist
- Provide a variety of administrative, secretarial, and clerical support services for the Intake & Enrollment and Marketing staff
- Serve as the initial contact for information and referral phone calls, providing information about the ElderPlace program and making internal and external referrals as appropriate
- Operates a responsive physician referral program
- Responsible for maintenance of web based scheduling program
- The Health & Welfare (H&W) Specialist plays an important support role in the operational success of H&W processes and procedures at client
- This individual will serve as H&W Human Resources Service Delivery (HRSD) support to our benefits administrator, vendors and the business in order to align operational solutions with company requirements, goals, and objectives
- Will serve as an overall subject matter expert of health and welfare programs administered by client HR Services including all processes, procedures, and policies
- Demonstrates ability to review and analyze data and identify trends and issues to resolve challenges in a timely manner
- Individual will be responsible for providing Ad Hoc reports, processing queries, reviewing data and trend analysis
- Position requires significant system and data knowledge to become the SME
Qualifications for referral specialist
- Written responses addressing the targeted questions (max
- 2 years of experience in computers
- Bachelor of Science or 5 years of experience in a clinical laboratory
- Thorough knowledge of laboratory specimen collection/processing procedures, shipping, turn around times, and specialty research testing
- Enthusiasm and willingness to work with others
- Able to perform multiple, concurrent tasks in a frequently stressful environment