Referral Specialist

Overview

Certified Community Behavioral Health Clinics (CCBHC’s) seek to improve the behavioral health of their communities by: providing outpatient mental and substance use disorder services; advancing integration of behavioral health with physical health care; assimilating and utilizing evidence-based practices on a more consistent basis; and promoting improved access to high quality care.

 

The Referral Specialist serves all of the clinical staff and must navigate and negotiate successful tracking and coordination of referrals; it requires highly technical clerical tasks, specific to an area of work.  The work includes responsibility for the preparation of specialized departmental documents; significant interpersonal staff and public contact, appropriate and professional conduct, independent judgment, discretion, and personal initiative; and use of Electronic Health Record (EHR) systems.

Responsibilities

Referrals:

• Develop and maintains effective relationships with outside medical offices for patients needing specialty care. Serves as liaison to medical offices, hospitals
• Ensure successful tracking and monitoring of referrals placed: follows up with patients and outside providers to ensure referral completed in EHR
• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety
• Prioritize Urgent referrals and follow entire process through to confirmed scheduled appointment
• Communicate and coordinate referral requests with outside specialists
• Re-refer/re-schedule patients if they do not make their original referred appointment
• Request authorizations from patient’s insurance companies required by specialists
• Request authorization extensions or adjustments as requested by specialists
• Provide contact information to patients asking for specific details about their appointments
• Answer, respond and document phone calls, requests, and questions from patients in a timely manner
• Routinely make notification phone calls to patients throughout the referral process
• Document every step of the patients’ referral process in EHR system
• Close the final loop in referral tracking and document patient completion in EHR
• Communicate information via computer, phone, fax, and in writing to appropriate resources
• Respond to In-house provider questions, requests, and concerns regarding the status of patient referrals, care coordination or follow-up status

 

Other duties:

• Knowledgeable of sliding fee scale for qualifying patients and can counsel and educate patients
• Assist with coverage of front desk as needed to handle patient needs
• Assist with coding and review of records for billing purposes
• Comply with Health Center’s policies and procedures
• Demonstrate professionalism, patience, and a high level of interpersonal and communication skills with patients, staff, visitors, and outside organizations
• Seek supervision and consultation as needed.
• Accept and employ suggestions for improvement.
• Actively work to enhance skills.
• Documents in a timely fashion per policy.
• Documents in a clear, legible, and concise manner.

 

 

Courteous and respectful towards consumers, visitors, and co-workers:

• Treats consumers with care, dignity and respect.
• Respect patient privacy and confidentiality.
• Pleasant and cooperative with others.
• Promote a professional work atmosphere

 

Administrative and Other Related Duties as assigned:

• Actively participate in AltaPointe committees as required.
• Accurately complete assigned tasks in a timely manner.
• Follows AltaPointe policies and procedures.

Qualifications

High School graduate or the equivalent. Proficiency in Excel; ability to problem solve and carry out task independently; Preferred experience in medical practices to include outpatient best practices, FQHC, coding and billing, Proficient with computer applications including Microsoft Office Suite, EMR and medical billing software, Knowledge of HIPAA.