Referral Specialist

SUMMARY

Coordinates patient referrals and obtains benefit/coverage information, assisting with care coordination and scheduling any necessary medical testing and/or outside appointments. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers, and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

RESPONSIBILITIES

Maintains ongoing tracking and appropriate documentation of incoming and outgoing patient referrals.

Ensures complete and accurate registration including:

• Patient demographics
• Current insurance information
• Medical records necessary for patient appointments

Assembles information concerning patient's clinical background and referral needs.

Per referral guidelines, provide appropriate clinical information to Specialists’ Office.

Contacts insurance companies to ensure prior approval requirements are met and present medical information such as history, diagnosis, and prognosis when necessary.

Reviews details and expectations about the referral with patients.

Assists patients in problem solving potential issues related to the healthcare system, financial and social barriers, e.g., request for interpreters, transportation services, or prescription assistance.

Acts as the system navigator and point of contact for patients and families, allowing them to have direct access for asking questions and raising concerns.

May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.

Ensures referral requests are addressed in a timely manner.

Sends consultation notes back to referring PCP for incoming pulmonary referrals.

Reminds patients of scheduled appointments via mail or phone.

Complies with federal and local confidentiality laws, including HIPAA, ensuring patient privacy.

Adheres to Brown Health Medical Group Primary Care guidelines for protecting patients’ demographic, clinical, and financial information.

Provides coverage for other areas/departments as needed.

Additional responsibilities as deemed necessary.

MINIMUM QUALIFICATIONS

Pay Range: $19.03-$31.39

Location: Brown Health Medical Group Primary Care - 593 Eddy St - Executive Suite Providence, Rhode Island 02903

Work Type: M-F 8:00-4:30

Work Shift: Day

Daily Hours: 8 hours

Driving Required: Yes

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.