Referrals Specialist

Description Neighborhood Outreach Access to Health (NOAH) is a Federally Qualified Health Center (FQHC) that offers comprehensive, integrated, and affordable healthcare services to people in need. We serve over 40,000 neighbors with a variety of services, including medical, dental, behavioral health, nutrition, preventive health, eligibility assistance, and health education programs.

At NOAH, we are dedicated to promoting the overall wellness of our employees by fostering a supportive and balanced work environment. We understand the importance of physical, mental, and emotional well-being, and we strive to create a workplace where our team members can thrive both personally and professionally. Join us in making a difference in our community while enjoying a fulfilling and rewarding career.

Job Summary The Referrals Specialist coordinates specialty referrals incoming and outgoing, eligibility verification, and maintenance for practice patients.

Duties/Responsibilities

• Obtains patient information and referral request documentation, maintains patient files, verifies information, and reports statistics and data.
• Compiles pertinent medical data and supporting documentation and sends to appropriate recipients.
• Verifies eligibility, benefits, and contractual appropriateness.
• Acts as liaison between practice, patients, referral sources, and health insurance companies to resolve complaints and problems.
• Serves as expert internal consultant to all levels of practice staff.
• Monitors and resolves the status of problem authorizations.
• Compiles patient information in accordance with their insurance plan’s referral requirements.
• Ensures prior approval requirements are met by contacting review organizations and insurance companies.
• Ensures that patient's primary care chart is up to date with information on specialist consults related to their health.
• Assists with training and orientation of new Referral Coordinator’s into practice.
• Trains new Referral Coordinator employees on correct policies and procedures as needed.
• Obtains information from multiple sources and completes data entry duties to update patient information in EMR system.
• Communicates with patients through EMR system, mail, or phone to confirm patient information, review details and expectations of referrals, and send reminders of upcoming appointments.
• Adheres to organizational policies, safety standards, and healthcare regulations, including HIPAA and other compliance requirements.
• Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.
• Performs other related duties as assigned.

Qualifications Required Skills/Knowledge/Abilities:

• Excellent verbal and written communication skills and ability to interact with individuals of various social, cultural, and educational backgrounds.
• Good organizational skills and administrative abilities.
• Knowledge of medical terminology.
• Excellent problem-solving and critical thinking skills.
• Detail-oriented and professional.
• Ability to exercise confidentiality, discretion, and good judgment.
• Proficient with Microsoft Office Suite and EMR software.

Required Education and Experience:

• High school diploma or GED required.
• 1+ years of Referral or related work experience required.

Other Requirements

• New Hires are required to pass pre-employment background check and drug testing (effective 11/1/2022).