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Referral Managment Specialist I

Company: Memorial Health System
Location: Springfield
Posted on: June 13, 2019

Job Description:

Position Summary: The Referral Management Specialist I reports to the Supervisor, Referral Management. Under general supervision, the Referral Management Specialist I will utilize tools designed to facilitate the referral process and schedule appointments for multiple specialties for Memorial Physician Services primary care patients or patients being discharged from Memorial Medical Center's Emergency Room. Working in an office setting, the Referral Management Specialist I will partner with Physician's to provide a resource for timely referrals that will increase clinical and operational processes which will positively impact patient safety and quality. The Referral Management Specialist I will ensure timely arrangement of appointments at specialty and primary care clinics, ensure patient and provider preferences are met when possible, ensure payer requirements for referrals are met, complete necessary payer prior authorizations, and communicate appointment details to patients, providers, and provider offices. The Referral Management Specialist I will follow all applicable regulations, policies, and guidelines to ensure compliant and appropriate management of patient referrals to specialty care. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. Minimum Qualifications: Education: High school diploma required Licensure/Certification/Registry: Certified Nursing Assistant (CNA) through state of Illinois or two years previous experience in a Primary Care Physician medical office or clinical setting required Experience: Previous clerical and EHR documentation experience preferred-specifically Allscripts EHR. Other Knowledge/Skills/Abilities: Strong knowledge of local physician networks and their associated specialties, including Springfield Clinic, SIU, OCI, Prairie and others. Strong general computer skills in Microsoft Office; especially Microsoft Excel spreadsheets, databases, and reporting tools strongly preferred. Working knowledge of insurance requirements and coverage. Understanding of insurance prior authorization processes and insurance referrals. Possesses strong medical terminology. Demonstrates understanding of evidence based healthcare. Demonstrates ability to work in a fast changing and ambiguous environment. Engaging service oriented skills required. Excellent organizational skills required. Demonstrates ability to be flexible and function in stressful situations. Excellent oral, written communications and interpersonal skills required. Demonstrates initiative, self-direction, and motivation. Demonstrates open/global communication skills with multiple requesters. Ability to work with multiple care providers and maintain positive working relationships. Required Skills Required Experience Job Location Springfield and surrounding cities, US-IL PandoLogic. Keywords: Referral Specialist, Location: Springfield, IL - 62707

Keywords: Memorial Health System, Springfield , Referral Managment Specialist I, Other , Springfield, Illinois

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