Referrals en Suncoast Community Health Centers Inc.

POSITION TITLE: REFERRALS

FLSA: NON-EXEMPT

Job Summary:

The Referrals Specialist coordinates and processes patient referrals, ensuring accurate documentation, insurance approvals, and timely follow-up. They work with patients, staff, and external providers to ensure access to care while maintaining compliance. The specialist also keeps detailed records and guides patients on next steps.

Duties/Responsibilities:

• Process patient referrals to internal and external specialists and services, ensuring timely and accurate submission of required documentation and insurance authorizations.
• Coordinate client referrals and communicate with outside agencies and providers to facilitate appointments and services.
• Track referral statuses and follow up with providers, patients, and external offices as needed to ensure timely completion.
• Maintain accurate and up-to-date referral records in both manual systems and the electronic health record (EHR) system.
• Instruct patients on referral procedures, providing clear information about timelines, required documentation, and follow-up actions.
• Collaborate with clinical and administrative staff to address referral-related inquiries and meet patient needs promptly.
• Identify and report issues in the referral process to the supervisor for corrective action.
• Ensure compliance with federal, state, and organizational policies related to referrals, including HIPAA privacy standards.
• Stay informed about changes in insurance policies, referral requirements, and provider networks to ensure smooth coordination.
• Assist with general office tasks, such as preparing reports on referral metrics, organizing documentation, and supporting team operations.
• Perform additional tasks as needed to support the centers.

Required Skills/Abilities:

• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills.
• Excellent organizational skills and attention to detail.
• Excellent time management skills with a proven ability to meet deadlines.
• Strong analytical and problem-solving skills.
• Ability to prioritize tasks and to delegate them when appropriate.
• Ability to function well in a high-paced and at times stressful environment.
• Must be able to effectively manage workflow and maintain high-quality standards in environments where staffing levels may be below ideal, demonstrating the ability to prioritize tasks and collaborate with the team under pressure.
• Ability to use office equipment, including computers, copy machines, fax machines, telephones, calculators, and more.
• Proficient with Microsoft Office Suite, Electronic Medical Records (EMR) and related software.

Education and Experience:

• High School Diploma or equivalent is required.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.
• Must be able to travel to various center locations as required.