Title: Referral Specialist
Reports To: Department Manager or Designee
EEOC: Administrative Support
FLSA Status: Non-Exempt
Responsible for the referral process, including but not limited to insurance verification, scheduling appointments, and verification of patient compliance. Develops extensive knowledge of community resources. Coordinates referrals with other project providers in a timely manner. Sets up a referral network to facilitate accessibility to the Center and other network provider agencies.
CS-HHC’s Expectations of all Employees
- Adheres to all CS-HHC Policies and Procedures
- Conducts self in a manner that represents CS-HHC’s Values at all times
- Maintains a positive and respectful attitude with all work-related contacts
- Communicates regularly with supervisor about Departmental and CS-HHC concerns
- Consistently reports to work on time, prepared to perform the duties of the position
- Meets productivity standards and performs duties as workload necessitates
Essential Duties and Responsibilities
- Obtains authorization from the appropriate insurance company for the specialist and/or procedure recommended
- Schedules appointments with the provider for the patient
- Provides patients with necessary information (appointment time, location, directions, any required preparations, etc.)
- Updates clients’ medical records with notes on services provided in the field
- Forwards any documents to the medical records department, and files in patient’s charts
- Establishes and maintains a “Follow-up Pending” system to ensure patient compliance is verified
- Electronically enters billing information into MIS system and transmits hard copy to billing department, as applicable
- Checks client eligibility for Accounts Payable and project vendors, as applicable
- Prepares new medical chart for clients seen off site and submits to Medical Records Department (Homeless Department only)
- Receives, places, and transfers calls to the appropriate department
- Establishes and maintains a good rapport with co-workers; responds to their requests with cooperation
- Attends in-service programs as directed
- Uses duty time in an appropriate and productive manner
- Demonstrates flexibility in work schedules and assignments
- Accepts and responds appropriately to supervisory directions
- Performs all other duties as required
To perform the job successfully, an individual should demonstrate the following competencies and skill sets:
Skill Set; Communications
Oral Communication – The ability to express oneself clearly in conversations and interactions with others. Speaks clearly and can be easily understood. Organizes ideas clearly in oral speech. Expresses ideas concisely in oral speech. Summarizes or paraphrases his/her understanding of what others have said to verify understanding and prevent miscommunication.
Written Communication – The ability to express oneself clearly in business writing. Expresses ideas clearly and concisely in writing. Organizes written ideas clearly and signals the organization to the reader (e.g. through an introductory paragraph or through the use of headings). Writes using concrete, specific language. Spells correctly. Writes grammatically. Uses punctuation correctly.
Interpersonal Awareness – The ability to notice, interpret, and anticipate others’ concerns and feelings, and to communicate this awareness empathetically to others. Understands the interests and important concerns of others. Notices and accurately interprets what others are feeling, based on their choice of words, tone of voice, expressions, and other non-verbal behavior. Understands the unspoken meaning in a situation. Says or does things to address others’ concerns.
Customer Orientation – The ability to demonstrate concern for satisfying one’s external and/or internal customers. Quickly and effectively solves customer problems. Talks to customers to find out what they want and how satisfied they are with what they are getting. Lets customers know he/she is willing to work with them to meet their needs. Helpful, positive manner with peers, subordinates and customers.
Skill Set; Achieve Results
Technical Expertise – The ability to demonstrate depth of knowledge and skill in key work process areas. Is sought out as an expert to provide advice or solutions in his/her area. Is knowledgeable in the tools used to support key work processes. Can train and coach key work processes to staff in their area. Is aware and follows agency policy and procedures consistently.
Initiative – Identifying what needs to be done and doing it before being asked or before the situation requires it. Seeks out others involved in a situation to learn their perspective. Takes independent action to change the direction of events.
Results Orientation – The ability to focus on the desired results of one’s own work, setting challenging goals, focusing efforts on the goals, and meeting or exceeding them. Maintains commitment to goals in the face of obstacles and frustrations. Finds or creates ways to measure performance against goals. Has a strong sense of urgency about solving problems and getting work done.
Thoroughness – Ensuring that one’s own work and information are complete and accurate. Sets up procedures to ensure high quality of work (e.g. review meetings). Verifies information. Checks the accuracy of own work. Develops and uses systems to organize and keep track of information or work in progress. Carefully prepares for meetings and presentations.
Skill Set; Self-Management
Stress Management – The ability to continue to function effectively when under pressure and maintain self-control in the face of hostility or provocation. Remains calm under stress. Can effectively handle several problems or tasks simultaneously.. Controls his/her response when criticized, attacked, or provoked. Maintains an appropriate sense of humor under difficult circumstances.
Personal Credibility – Demonstrated concern that one be perceived as responsible, reliable, and trustworthy. Does what he/she commits to doing. Is honest and forthright with people. Takes responsibility for own mistakes; does not blame others. Conveys a command of the relevant facts and information.
* Competencies sourced from “The Value Added Employee” by Edward J Cripe and Richard S. Mansfield, Copyright 2002 by Workitect Inc.
Education: High School Diploma or equivalent required. Certified Nurses Assistant or Certified Medical Assistant preferred.
Experience: Minimum of six (6) months of related experience. Experience in a customer service orientated position and knowledge of medical terminology preferred.
Knowledge/Abilities: Excellent customer service skills required. Must be a team player and present excellent organizational skills. Excellent communication skills, both verbal and written are required. Ability to work under pressure is essential. Excellent computer skills and familiarity with Microsoft, Internet and E-mail is required. Ability to speak both English and Spanish is preferred. Must demonstrate age specific/population specific competencies in area(s) of practice.
Physical Demands/Working Conditions
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand or sit for extended periods of time. The employee must occasionally lift and/or move up to 25 pounds.
Travel within the State of Connecticut is required on an as needed basis.
How to Apply
Cornell Scott – Hill Health Center