Referral Specialist - Brown University Health

Summary:
Coordinates patient referrals and obtains benefit/coverage information assisting with care coordination and scheduling any necessary medical testing and/or outside appointments.

Responsibilities:
Maintains ongoing tracking and appropriate documentation of incoming and outgoing patient referrals
Ensures complete and accurate registration including: patient demographics current insurance information and medical records necessary for patient appointments
Assembles information concerning patient's clinical background and referral needs
Per referral guidelines provide appropriate clinical information to Specialists� Office
Contacts insurance companies to ensure prior approval requirements are met and present medical information such as history diagnosis and prognosis when necessary
Reviews details and expectations about the referral with patients
Assists patients in problem solving potential issues related to the healthcare system financial and social barriers e.g. request for interpreters transportation services or prescription assistance
Acts as the system navigator and point of contact for patients and families allows them to have direct access for asking questions and raising concerns
May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion
Ensures referral requests are addressed in a timely manner
Send consultation notes back to referring PCP for incoming pulmonary referrals
Reminds patients of scheduled appointments via mail or phone
Complies with federal and local confidentiality laws including HIPAA ensuring patient privacy
Adheres to Brown Health Medical Group Primary Care guidelines for protecting patients� demographic clinical and financial information
Provides coverage for other areas/ departments as needed
Additional responsibilities as deemed necessary

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Brown University Health is a VEVRAA Federal Contractor.

Location: Brown Health Medical Group Primary Care USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union