Referral Specialist

Job Description

Job Description

Summary:

The Referral Specialist is Southeastern Integrated Care’s system navigator and point of contact for clients, families, multiple referral sources, payers, and our network of providers assuring clients have direct access to immediate and ongoing care and families, with patients and families having direct access for asking questions and raising concerns. Will assertively assume the advocate role on our clients behalf with the referral source and or payer to ensure approval of the necessary services for the client in a timely fashion. Will serve as the primary communicator with all parties involved in the initial intake/admission process of delivering the ongoing care and recovery of our clients.

Essential Responsibilities:

1. Ensure all methods of referrals are captured in EMR system- (i.e., electronic fax, QR codes, alpha and MCO calendars, walk ins, phone, text, etc.
2. Collect all referrals to include all enhanced services and residential (adult/youth).
3. Communicate with integrated care staff about client’s care to include scheduling and delivery of services.
4. Coordinate/schedule meet/greet with referral sources for youth.
5. Create client demographics information and upload documentation into the system.
6. Develop relationships with new and existing clients, partners, and stakeholders.
7. Attend community events to learn about new trends and build relationships with industry partners.
8. Communicate with referral source prior to intake and post intake status of visit.
9. Identify all referral sources, names, numbers, emails inclusive of direct referral, care managers, hospital or DSS, payer source, etc.
10. Review treatment recommendations of referral source, and Director of clinical Operations
11. Send out reminder calls to client prior intake
12. Communicate with primary referral sources if client is a NO SHOW or reschedules. Complete referral feedback form and update contact log weekly.
13. Gather all referrals fax, email, phone calls, QR code, alpha etc. and reach out to client.
14. Verify coverage insurance options
15. Communicate back with all referrals sources outcomes of CCA and treatment recommendations
16. Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness. The goal is for 95% of all referrals to be admitted to treatment.
17. Ensure complete and accurate registration, including patient demographic and current insurance information.
18. Assist clients with problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
19. Collaborates with Clinical Operations Director and Referral Manager to assure all referrals are accurately assessed and started in the appropriate level of care in a timely fashion
20. Other duties as assigned.

Education/Experience:

• Bachelor’s degree in Human Service field with 2 years full-time, accumulated MH/DD/SAS experience with population, OR
• Bachelor’s degree in a field other than Human Services with 4 years full-time, accumulated MH/DD/SAS experience with population, OR
• An individual who holds a license of Registered Nurse (RN) in North Carolina, and also has 4 years of experience with MH/DD/SAS population. OR
• Master’s degree in Human Services field and has 1 year of full–time post-graduate degree accumulated MH/DD/SAS experience with population.

Job Qualifications and Skills:

• QP level credentials to include 2-3 years of experience working in the healthcare field.
• Demonstrated leadership skills including excellent oral and written communication skills.
• Strong knowledge of healthcare clinical fundamentals, client safety standards, and performance improvement standards.

• Strong client service focus
• Strong work ethic
• Effective verbal and written communication skills
• Comprehensive knowledge of EMR system
• Comprehensive knowledge of community resources
• Teamwork orientation
• Organized and able to manage competing priorities
• Good judgment
• Resourcefulness in problem solving
• Exceptional follow through
• Able to take and follow through with delegated tasks and accountability.

• Computer skills and knowledge of applicable software programs to include Microsoft Office and Excel.
• Professional demeanor and positive attitude to represent SEIC in the community as well as in the office
• Ability to work with diverse populations
• Flexibility with schedule

Supervisory Responsibilities:

This position does not oversee staff.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work is typically performed in an office environment, with a moderate noise level.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; talk and hear; and taste and smell. The employee frequently is required to reach with hands and arms and stoop, kneel, crouch, or crawl. The employee is occasionally required to sit and climb or balance. The employee must be able to lift and/or move up to 20 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Must be able to drive and operate a personal vehicle safely and adhere to all applicable state and traffic laws.