Overview

Full Job Description
Premier HealthCare (Premier), a member of the YAI Network, is recognized by the US Surgeon General as a national model for the provision of health care, and by the National Council on Disabilities for raising the national standards of health care services for children and adults with developmental and intellectual disabilities. Premier has also earned national certification as a Level 3 Patient-Centered Medical Home by the National Committee on Quality Assurance (NCQA).

Premier is unique in its quality of medical, dental, mental health, rehabilitation, and specialty care provided to people with disabilities and their families. With medical professionals and physicians affiliated with major hospitals in the New York metropolitan area, Premier has practices conveniently located in the Bronx, Brooklyn, Manhattan, and Queens.

Premier fosters a culture of interdisciplinary collaboration, ongoing opportunities for professional development, and a positive work environment with supportive supervision. Premier is technology and outcomes driven.

Premier, a member of the YAI Network, is seeking a full-time Referral Specialist at our outpatient medical facility in Brooklyn:

Essential Job Functions, Duties, and Responsibilities: The following list of duties is not intended to be restrictive or all inclusive. The fact that certain duties may not be listed does not limit the assignment of additional and/or other duties.

1. Under the direct supervision of the Site Manager, serves as primary resource for arranging and scheduling patients’ referrals.

2. Obtains necessary pre-authorization approval and refers patients to authorized providers as required by the insurance company. Also, obtains primary care physician approval for patient referrals as required by the insurer.

3. Consistently keeps patients abreast of any additional information needed by the Physicians Office insurance company, or other healthcare provider involved in the referral process. Establishes rapport with patients and family by facilitation open conversation during the referral process.

4. Provides education and information to co-workers and other staff as it relates to referrals.

5. Refers patients to participating providers within the appropriate network to maintain maximum financial incentives/reimbursement from payors as directed by provider. Assists provider in identifying appropriate network/healthcare provider to use for referrals as necessary. Referrals are made to authorized providers as specified by the insurer.

6. Schedules referral appointments for consultation by a specialist, diagnostic procedure or surgical procedure.

7. Prioritizes work to ensure that urgent referrals are handled expeditiously and routines are handled on a first come, first serve basis.

8. Ensures that proper documentation is forwarded to consulting physicians and facilities performing procedures as required. Copies of documentation are retained in the patient’s medical record.

9. Maintains insurance referral information for the practice ensuring that it is current, organized and assessable to providers and staff.

10. Serves as a resource to patients, providers and staff to facilitate the referral process in a timely and accurate manner.

Knowledge, Skills, and Ability Requirements

1. Maintains a level of computer literacy (i.e. applications, software and hardware), which is consistent with the expectations of the position.

2. Interacts with co-workers and other staff in a courteous and professional manner offering assistance as available.

3. Knowledge of patient confidentiality and HIPAA regulations

4. Excellent written and verbal skills are required as well as outstanding interpersonal skills

5. Practices efficient methods for getting work done; strong ability to prioritize workload

6. Organized; sets priorities; meets deadlines

7. Ability to work independently.

8. Must be able to adapt to change in the work environment, accept and give constructive criticism and feedback, effectively handle multiple tasks and completing demands, work cooperatively in group situations, and work actively to resolve conflicts.

9. Must be able to work in a very stressful environment where constructive feedback from others is encouraged.

10. Must work well with others on a team.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.

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