Care Access Referral Specialist-Providence - USA Health

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.

USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.

Serves as key personnel for USA Health’s central referral center and is a key source of general health and clinical program information and support for all of the departments across the ambulatory enterprise of USA Health; under general supervision and according to established policies and procedures, the Care Access- Referral Specialist is responsible for providing accurate and efficient referral coordination for patients being referred by and into USA Health ambulatory enterprise, including coordination with HCA; the Care Access Referral Specialist is responsible for, but not limited to, making outbound calls to patients and/or physician offices to obtain referral preferences and to obtain appointment details; taking general inbound calls from the Request an Appointment and Patient Navigator line, and any other main referral source within our clinics and practices; supporting the clinics by managing the referrals that are obtained through faxes; the Care Access Referral Specialist must be able to provide high levels of customer service when assisting customers, as the CARS is seen as a primary entry point for USA Health; this position works in a variety of electronic healthcare systems and is directly responsible for, but not limited to, explaining policies of the organization and department, providing general information, reviewing health information via Electronic Medical Record (EMR), scheduling appointments, pre-registering patients, coordination of medical records collection, insurance verification, coordination with other personnel of prior authorizations if warranted, communication to the clinic staff via the EMR and/or the telephone, facilitating access to nurse triage via EMR or live transfer if necessary, and functioning to support and provide immediate access and resolution for patients calling for referral services; this position serves as consultation and referral support for the Referral Team, as part of the Care Access Department at USA Health; manages referral queue; obtains necessary insurance plan information; maintains ongoing documentation and tracks authorized referrals; ensures that all referrals are properly linked to appointments; schedules appointments consistent with patient needs and clinic scheduling guidelines; assembles and sends appointment and other information; maintains current and accurate system by entering canceled and rescheduled appointments; coordinates and schedules ancillary appointments and consult appointments; completes proper authorization coordination as deemed necessary for assigned referrals; supports other online referral functions through web-based software and functionality (formstack, portal, etc); reviews daily assigned schedules to identify required medical record requests and/or collections; orders, coordinates, and distributes medical records as needed; prepares medical record according to clinic-specific procedures for patient visit; assembles and maintains communication to appropriate clinic personnel around medical records according to the Care Access and Ambulatory Standard Practice policies and procedures; answers general referral inquiries in a professional, courteous, and efficient manner according to USA I.D.E.A.L. customer service standards; supports calls as appropriate based on services deemed necessary; communicates information on USA Health programs to patients, referral agencies, University departments, physicians and the community; communicates basic information to patients and customers such as parking, driving directions, etc in support of the referral contact; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.

High school diploma or equivalent and four years of clerical experience in an access center, customer service, or healthcare setting.  Experience with databases and Electronic Medical Records is preferred. Experience with referral tracking software, Cerner, and Careweb is preferred. Experience with precertification and referral management for insurance plans is preferred.