<h3>Job Description</h3>
Job Description
POSITION SUMMARY:
Under the direct supervision of the Manager, Utilization Management, this position is responsible for processing and coordinating specialty referrals by working closely with the referring Providers, specialists, and patients. In a Patient-Centered Medical Home, this position systematically tracks tests, referrals, and care transitions to achieve high-quality care coordination, lower costs, improve patient safety, and ensure effective communication with specialists and other providers in the medical neighborhood. The Referral Specialist collaborates very closely with each patient’s primary care provider (PCP) and care team to address any ongoing issues related to a patient’s referral.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
<ul>
<li>Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.</li>
<li>Assemble information concerning the patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to the specialist.</li>
<li>Contact review organizations and insurance companies to ensure prior approval and authorization requirements are met. Present necessary medical information such as history, diagnosis, prognosis, and other clinical results.</li>
<li>Review details and expectations about the referral with patients.</li>
<li>Be the system navigator and point of contact for patients, with patients having direct access to asking questions and raising concerns. May assume an advocate role on the patient's behalf with the carrier to ensure approval of the necessary services for the patient in a timely fashion.</li>
<li>Ensure that referrals are addressed in a timely manner.</li>
<li>Ensures patients’ scheduled appointments via mail or phone. Works with patients to schedule appointments as needed.</li>
<li>Ensure that the patient's primary care chart is up to date with information on specialist consultations and reports.</li>
<li>Responsible for tracking referrals until the specialist’s report is available to the PCP, flags, and follows up on overdue reports.</li>
<li>May perform other duties as assigned.</li>
</ul>
QUALIFICATIONS AND SKILLS REQUIRED:
<ul>
<li>High school diploma or equivalent.</li>
<li>One (1) year of medical front or back-office experience.</li>
<li>Must have experience in Referral Processing through the MedPoint Portal/eConsult.</li>
<li>Knowledge of medical terminology and familiarity with the operation. Knowledge of PC operation preferred. Interpersonal and excellent verbal communication skills.</li>
<li>Knowledge of medical terminology and third-party payer requirements is also required.</li>
<li>Demonstrated excellence in customer service and/or patient care skills.</li>
<li>Requires demonstrated organization, interpersonal communication, and strong computer skills.</li>
<li>Incumbents must demonstrate problem-solving and prioritization skills to manage multiple tasks successfully throughout the day.</li>
<li>Effective verbal and written communication skills.</li>
<li>Good judgment.</li>
<li>Teamwork orientation.</li>
</ul>
SEIU 721 Position (Union)
COVID-19 CONSIDERATIONS:
All patients are subjected to COVID screening and are required to wear a mask when not receiving treatment. All staff members must be fully vaccinated.
Job Type: Full-time
Pay: $21.00 per hour
Expected hours: 40 per week
Application Question(s):
<ul>
<li>Do you have experience in Referral Processing through MedPoint Portal/eConsult?</li>
</ul>
Education:
<ul>
<li>High school or equivalent (Required)</li>
</ul>
Experience:
<ul>
<li>Medical terminology: 1 year (Preferred)</li>
<li>Medical front or back office: 1 year (Required)</li>
</ul>
Work Location: In person
Company DescriptionWith over 50 years of service, our goal is to improve the health of the community we serve by creating easier access to quality clinical, preventative, and specialty healthcare services. Watts Healthcare Corporation is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act. 
<h3>Company Description</h3>
With over 50 years of service, our goal is to improve the health of the community we serve by creating easier access to quality clinical, preventative, and specialty healthcare services. Watts Healthcare Corporation is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act.

Referral Specialist

<h3>Job Description</h3>
Description Location: UCHealth UCHlth 2450 Peoria Admin Services, US:CO:Aurora Department: UCHlth Patient Line Referrals FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $19.67 - $25.57 / hour. Pay is dependent on applicant's relevant experience Summary: Ensures compliance with managed care, commercial insurance, and public insurance requirements. Submits and tracks referrals. Provides efficient patient flow and service excellence. Responsibilities: Verifies eligibility and benefits; obtains authorizations for treatment or precertification of high cost drugs. Tracks referrals to ensure compliance with guidelines. Tracks formulary requirements. Responds to third party payors, employers, internal staff, and physician questions. Maintains information on health plan guidelines. Provides training on plan requirements. Obtains Advance Beneficiary Notice (ABN) or Notice of Exclusions from Medicare Benefits (NEMB) if required. Ensures provider compliance with plan guidelines. Ensures confidentiality of patient and institutional information. Provides routine information to customers and relays information appropriately. Monitors patient needs and responds to inquiries. Prepares written reports. Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action. Requirements: 
<ul>
<li>High School diploma or GED. Preferred: Associate's degree.</li>
</ul>
 We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives. UCHealth invests in its Workforce. UCHealth offers a Five Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of five years' employment. UCHealth offers their employees a competitive and comprehensive total rewards package: 
<ul>
<li>Full medical, dental and vision coverage</li>
<li>Retirement plans to include 403(b) matching</li>
<li>Paid time off. Start your employment at UCHealth with PTO in your bank</li>
<li>Employer-paid life and disability insurance with additional buy-up coverage options</li>
<li>Tuition and continuing education reimbursement</li>
<li>Wellness benefits</li>
<li>Full suite of voluntary benefits such as identity theft protection and pet insurance</li>
<li>Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may also qualify for up to $5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year</li>
</ul>
 Loan Repayment: 
<ul>
<li>UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.</li>
</ul>
 UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified. UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any "qualified applicant with a disability" as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization. Who We Are (uchealth.org) AF123

<h3>Job Description</h3>
Job Description
DCI Donor Services (DCIDS) is looking for a dynamic and enthusiastic team member to join us to save lives!! Our mission at DCIDS is to save lives through organ donation, and we want professionals on our team that will embrace this important work!! We are specifically wanting people to join our team as a Referral Screening Specialist. This position will medically screen and review donor referrals by phone and make the medical evaluation for potential donor suitability. This position will work both in an office environment and from home. Strong interpersonal skills and the ability to communicate effectively in both oral and written formats are a must.
COMPANY OVERVIEW AND MISSION
For over four decades, DCI Donor Services has been a leader in working to end the transplant waiting list. Our unique approach to service allows for nationwide donation, transplantation, and distribution of organs and tissues while maintaining close ties to our local communities.
DCI Donor Services operates three organ procurement/tissue recovery organizations: New Mexico Donor Services, Sierra Donor Services, and Tennessee Donor Services. We also maximize the gift of life through the DCI Donor Services Tissue Bank and Sierra Donor Services Eye Bank.
Our performance is measured by the way we serve donor families and recipients. To be successful in this endeavor is our ultimate mission. By mobilizing the power of people and the potential of technology, we are honored to extend the reach of each donor’s gift and share the importance of the gift of life.
We are committed to diversity, equity, and inclusion. With the help of our employee-led strategy team, we will ensure that all communities feel welcome and safe with us because we are a model for fairness, belonging, and forward thinking.
 
Key responsibilities this position will perform include:
· Facilitates the donation process through coordination and communication of referral information and logistics. Appropriate routes all donor referrals and request from externals.
· Maintains accurate documentation of the medical screening process via data entry and follows established referral intake procedures.
· Evaluates medical suitability of potential organ and tissue donors by utilizing information from medical records, personal histories, physical examination, and current health status. Transcribes health information into electronic medical records.
· Requests and interprets laboratory and diagnostic tests needed for evaluation of suitability and clinical management of potential donors.
· Collaborates with hospital personnel and clinical teams to develop an action plan that supports the option of donation is maintained and activation of the appropriate DCIDS team members.
· Participates in training, process improvement, departmental QA/QC activities and special projects as directed.
· Performs other related duties as assigned.
 
The Referral Screening Specialist will work on a rotating 12-hour shift from 6:00 PM-6:30 AM. The position will perform on a 2 week rotating schedule (Week 1 - Sun, Wed, Thurs. Week 2 - Mon, Tues, Fri, Sat.)
The ideal candidate will have:
· 2+ years emergency or critical care experience in a healthcare setting · Demonstrated ability to understand medical terminology and read a medical chart. · Exceptional teamwork, communication, and conflict management skills. · Valid Driver’s license with ability to pass MVR underwriting requirements
We offer a competitive compensation package including:
· Up to 176 hours of PTO your first year · Up to 72 hours of Sick Time your first year · Two Medical Plans (your choice of a PPO or HDHP), Dental, and Vision Coverage · 403(b) plan with matching contribution · Company provided term life, AD&amp;D, and long-term disability insurance · Wellness Program · Supplemental insurance benefits such as accident coverage and short-term disability · Discounts on home/auto/renter/pet insurance · Cell phone discounts through Verizon
**New employees must have their first dose of the COVID-19 vaccine by their potential start date or be able to supply proof of vaccination.**
DCIDS is an EOE/AA employer – M/F/Vet/Disability.
Job Type: Full-time
Ability to commute/relocate:
<ul>
<li>Nashville, TN 37228: Reliably commute or planning to relocate before starting work (Required)</li>
<li>Knoxville, TN 37909: Reliably commute or planning to relocate before starting work (Required)</li>
<li>Albuquerque, NM 87102: Reliably commute or planning to relocate before starting work (Required)</li>
</ul>
 
License/Certification:
<ul>
<li>Driver's License (Required)</li>
</ul>

Referral Screening Specialist

<h3>Job Description</h3>
Job Description
Matthew Walker Comprehensive Health Center has an exciting opportunity available for a skilled, resourceful, and motivated individual who would like to make a difference in the lives of others in helping a non-for-profit organization fulfill its mission to provide quality health care. Reporting to the PCMH Quality Improvement Manager, the Referral Specialist (RS) will be responsible for the following to include, but not limited to:
· Processing patient referrals in a timely manner and responding to general information inquiries
· Answering a high volume of incoming telephone calls from patients, insurance companies and other healthcare providers
· Ensuring ICD-9 and CPT codes are accurate on referral authorizations prior to submitting them to the insurance company
· Responding to information requests from various parties regarding referrals or other pertinent medical requests for patients
· Ensuring referral requests are processed and documented completely and in a timely manner
· Obtaining prior authorization from insurance carriers and following up to ensure referral appointments are kept by patients
· Working cooperatively with insurance companies, patients, center and administrative staff
· Case coordinating for chronic diseases and preventive care for patients
EDUCATION/EXPERIENCE: 
High School diploma, or equivalent, is required. College degree or higher education level is preferred. The RS should possess stellar customer service, communication, and organizational skills with an acute attention to detail. Knowledge of and the ability to use an automated call distributor telecommunication system is preferred.

<h3>Job Description</h3>
Job Description
We are seeking a Referral Coordinator to join our team! You will be responsible for scheduling new patients and f/u patients.
Responsibilities:
<ul>
<li>Schedule appointments with new patients and f/u patients</li>
<li>Obtain authorizations for the services</li>
<li>Resolve patient inquiries and complaints</li>
<li>Maintain record of patient contact information in the EMR</li>
<li>Perform other duties as assigned</li>
</ul>
​Qualifications:
<ul>
<li>Previous experience in referrals and authorizations</li>
<li>Strong negotiation skills</li>
<li>Ability to build rapport with patients</li>
<li>Excellent written and verbal communication skills</li>
</ul>
Company DescriptionNeurology and Sleep Medicine Clinic 
<h3>Company Description</h3>
Neurology and Sleep Medicine Clinic

Referral/Benefits Specialist

<h3>Job Description</h3>
Job Description
Responsibilities:
The Information and Referral Specialist primary responsibilities are handling a large number of incoming and outgoing calls. Assessing callers needs for service, assigning referrals to appropriate CILSF staff for follow up and/or provide community-resources and referrals. This position requires a person with a pleasant disposition who can coordinate numerous tasks, including but not limited to referrals to community resources, linkage to community services, maintaining an up to date resource registry/community resources and administrative duties. Visitors will be identified/referred to appropriate CIL staff. 
Supports the Marketing &amp; Outreach Department by representing the organization at various community events and meetings, which may fall within evening hours and on the weekends.
Other tasks as assigned.
Requirements:
<ul>
<li>
Must be bi-lingual (English &amp; Spanish).
</li>
<li>
Must have a Bachelor's degree in a related field (Business, Social Work) or an Associate degree plus 2 years of experience working in social services or related fields.
</li>
<li>
Must have reliable transportation.
</li>
<li>
Receive phone calls, video calls, and walk-in inquiries; operate telephone systems, screen and refer calls, take messages, assign to appropriate staff, alternative offices, and/or any individuals within the agency. 
</li>
<li>
Provide information and referrals to other community agencies, follow up to ensure that the caller has connected with appropriate resources.
</li>
<li>
Receives and distributes information relevant to CILSF and to the disability community, as well as the community at large, including overseeing any CILSF marketing material displayed in reception. 
</li>
<li>
Process incoming /outgoing correspondence using appropriate mailing service/courier; and administrative duties.
</li>
<li>
Must be able to cultivate relationships with consumers, peers, community networks and stakeholders.
</li>
<li>
Must feel comfortable presenting the organization's services to various audiences.
</li>
<li>
Must have a basic understanding of the agency’s services and Miami Dade County community social services and community resources.
</li>
<li>
Must possess advanced computer skills and be Microsoft Office and Zoom proficient.
</li>
<li>
Maintaining front reception area presentable for visitors and consumers at CILSF 
</li>
<li>
Must be willing to occasionally work weekends and nights as needed with occasional travel as needed.
</li>
</ul>
People with disabilities are encouraged to apply.
CILSF is an equal opportunity employer.
Interested candidates asked to e-mail resumes to <a href="mailto:maria@cilsf.org" target="_blank">maria@cilsf.org</a>, attention to: Ms. Rodriguez.
Company DescriptionThe Center for Independent Living of South Florida, Inc. (CILSF) is a registered 501(c)(3), or nonprofit, that empowers people of all disabilities and ages across Miami-Dade to maximize their abilities to live independently and challenge barriers that prevent us from being a fully integrated community. 
<h3>Company Description</h3>
The Center for Independent Living of South Florida, Inc. (CILSF) is a registered 501(c)(3), or nonprofit, that empowers people of all disabilities and ages across Miami-Dade to maximize their abilities to live independently and challenge barriers that prevent us from being a fully integrated community.

Information and Referral Specialist

<h3>Job Description</h3>
Job DescriptionBenefits: 
<ul>
<li>401(k)</li>
<li>Dental insurance</li>
<li>Health insurance</li>
<li>Paid time off</li>
</ul>
 Seeking full- time experienced check out / Referrals coordinator for a busy Internal Medicine office. Must be able to multitask while maintaining attention to detail. Job duties include but are not limited to: Checking out all patients seen during the day referrals to other doctors referrals for all radiology testing ordered by providers obtaining prior authorizations from insurance companies for referrals to other specialist scheduling follow up appointments check voicemails and return patient calls getting patients in stat to other providers or for testing when needed *excellent verbal skills and communication *excellent patient care *computer knowledge (NEXTGEN experience is a plus) *knowledge of CPT and ICD-10 codes *Knowledge of medical terminology

check out/referral specialist

<h3>Job Description</h3>
Job Description
Ocala Ear, Nose, &amp; Throat Specialists is a thriving private ENT practice. As our practice continues to grow, we have new employment opportunities available.
We are seeking a person with a minimum of 2 years of experience in referrals/authorizations in a medical office setting. Referral and general pre-certification experience is required for this position. The employee is responsible for all necessary referrals and authorizations while meeting and exhibiting standards of excellence in customer service.
This employee will:
<ul>
<li>Determine the necessity for referral and pre-authorization.</li>
<li>Obtain referrals and authorization for scheduled procedures quickly and efficiently</li>
<li>Contact Referring Physicians for clinical information when needed</li>
<li>Monitor schedule for add-on patients and obtain appropriate information</li>
<li>Notate updated information in the computer system</li>
<li>Inform management of any pending issues that might delay the ability to schedule or perform scheduled testing.</li>
<li>Ensures confidentiality of all health information as required by HIPAA guidelines, ensuring compliance</li>
<li>Establishes a good working relationship with the Primary Care Physician's office,</li>
<li>Maintains a thorough understanding of all major insurance carriers' benefit verification and authorization processes. Keeps current with updates for various health plans.</li>
<li>Maintains and utilizes online access to major insurance carriers.</li>
</ul>

Referral/Prior Authorization Specialist

&lt;b&gt; Facility: Wellstar Cobb Gynecologists - Dallas&lt;/b&gt;&lt;br&gt;&lt;br&gt;&lt;b&gt;Job Summary:&lt;/b&gt;&lt;br&gt; The Referral Specialist is responsible for handling the referral process for specialized procedures in the ambulatory setting, ensuring that appropriate authorizations are requested, received and recorded in tapestry. Acts as the primary source for staff regarding authorizations, insurance plans, and specific procedural codes. The job duties include tracking of the patients and ensuring follow through. This is a clerical position working in a clinic with multiple providers and support staff. Work situations require a poised individual, courteous manner, discretion, organization skills, and good judgment. Knowledge of all department functions and various insurance plan provisions is essential. This position requires extensive interaction with external customers to include other physician offices, insurance plans, and patients. Internal contacts include the nursing staff, providers, and centralized call center staff. &lt;br&gt;&lt;b&gt;Core Responsibilities and Essential Functions:&lt;/b&gt;&lt;br&gt; Principal Accountabilities - Coordinates and processes authorizations - Acts as the liaison between the specialist, primary care physician and insurance carrier to ensure appropriate authorization for specialty procedures. Communicates all insurance concerns to the specialist. - Ensures all authorizations are requested with appropriate ICD9 / CPT codes and includes clinical data to support request. - Expedite the authorization process by monitoring and tracking the special procedure database (tapestry). - Updates tapestry with valid authorization codes, date of service, and insurance contact information. - Tracks and monitors all clinic authorizations and referrals. - Documents referrals and all conversations regarding authorization request in the electronic medical record. - Responds to all patient's insurance questions/concerns. - Responds to all required insurance data requests in a timely manner. - Advocate for, and generates appeals and troubleshooting patient needs. - Maintains utilization data on managed care patients. - Responds to all phone calls from patients, physician offices and insurance plans on referrals made. - Coordinates all aspects of managed care operations. - Coordinates review of all clinic authorizations with Patient Care Manager, Providers and support staff as necessary. - Researches patient eligibility and benefits; corresponding with patient accounts and faxing requested documentation. - Contributes to the success of the organization by meeting organizational competency expectations and core values (respect, integrity, stewardship, excellence, collaboration and kindness), continuously learning, and by performing other duties as needed or assigned. &lt;br&gt;&lt;b&gt;Required Minimum Education:&lt;/b&gt;&lt;br&gt; High school graduate or equivalent Required &lt;br&gt;&lt;b&gt;Required Minimum License(s) and Certification(s):&lt;/b&gt;&lt;br&gt;&lt;br&gt;&lt;b&gt;Additional Licenses and Certifications:&lt;/b&gt;&lt;br&gt;&lt;br&gt;&lt;b&gt;Required Minimum Experience:&lt;/b&gt;&lt;br&gt; Minimum 2 years clerical experience Required or medical office Preferred or Experience with CPT and ICD-9 coding Preferred &lt;br&gt;&lt;b&gt;Required Minimum Skills:&lt;/b&gt;&lt;br&gt; Knowledge of and skill in the use of personal computer and related software. Knowledge of medical terminology and medical ethics. Time management, good grammar and spelling, good interpersonal skills. Ability to deal with difficult people or situations in a professional manner. Ability to train staff of all levels. Ability to work efficiently under pressure, with a high degree of accuracy. Ability to work independently and take initiative. Ability to exercise discretion and maintain confidentiality.

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