Referral and Authorizations Specialist

Position Summary: In accordance with the Centers policies and procedures, the referral Specialist functions under the direction of the referral Coordinator. This position is responsible for the planning, implementation, and follow-up of patient referrals generated by the primary care physician.

Essential Functions: • Develops a comprehensive reference file of patient referral sources; serves as a resource person to other staff regarding the referral process • Utilize physician orders and medical assistant or nursing skills to prioritize patient referral needs • Schedule referral appointments timely • Follows assigned rotation schedule to specific centers to process referrals; responsible for managing referrals at rotation sites to prevent back-log • Initiates and assists in health education for patient and family • All routine referrals to be initiated within 10 working days; ASAP referrals initiated within 3 working days; urgent referrals to be initiated within 24 hours; mail appropriate copy of referral to third party payer • Thoroughly and accurately document referral efforts and outcomes; track referrals to ensure follow-up compliance • Keep accurate, complete and current referral logs • Collaborates with Case Managers and managed care providers to determine patient eligibility • Identifies referrals to be schedule by other staff in accordance with the referral degree of difficulty • Order referral forms from respective sources, as assigned • Effectively utilize EHR to assist in the comprehensive scheduling and follow-up of referrals • Alert appropriate care team members to challenges with referral funding • Communication of referral status to physician, as appropriate • Keep current in changes in managed care policies as related to the processing of referrals • Collaborate with Medical Social Worker to identify and address financial assistance needs of patients to access specialty care

General Duties: • Support the Mission, Vision and Values of Tampa Family Health Centers • Performs clerical duties for Referral Service department including: • Responds to calls in a timely manner • Assists clinical team with urgent referrals as needed • Assist internal and external customers with All referral needs • Interact with clinicals staff

Knowledge and Experience: • Strong communication skills, both oral and written • Detailed -Oriented • Ability to multi-task in a fast-paced environment • Strong organization and prioritization skills • Minimum (1) years referral experience • Great work ethic

Education, Certification Training and License: • High School graduate or equivalent • Prefer experience with Microsoft applications • Prefer previous medical front desk (verification/eligibility)