Job Description
Referrals Navigator
Job purpose
To assist clinicians and patients in managing specialty and diagnostic referrals. When necessary navigates patients through the health care system from the initiation of the referral, to obtaining prior authorization, scheduling appointments and tracking and following up on results.
Duties and responsibilities
Works in close partnership with the clinical teams to manage all aspects of external referrals.
Obtains prior authorization for referrals when necessary.
Makes appointments and any additional referral arrangements with patient referral sites.
Documents all aspects of the referrals process in the patient’s Electronic Health Record and communicates with referring clinicians when patients cannot be reached.
Educates patients related to requirements of referrals, referral sites/ locations and/or appointment specifics.
Works with the Referrals Supervisor to educate clinicians on changes to the referrals process.
Works with the Referrals Supervisor, Executive Management and Department Chairs to identify Performance Improvement needs and strategies for managing, tracking and following up on referrals.
Manages a system for follow up of referrals, by maintaining a searchable database, as directed by the Referrals Supervisor.
Works with teams and individual providers to clarify access issues, or other barriers for particular referrals or groups of referrals.
Familiarizes self with and acts as an expert related to insurance practices and coverage or referrals by various payer sources.
Ensures patient confidentiality, and provides patients with needed information.
Performs other necessary duties as required by FHCHC to achieve the goal of providing high quality services and primary health care
Qualifications
One year of experience in a health care setting required
Referrals experience preferred
Principles of proficient data entry, preferably using a database such as Excel and/or Access
Excellent communication skills, pleasant attitude, ability to accept constructive criticism, and an ability to work well with staff and patients
Preferably multi-lingual in English and Spanish
Technical Qualifications
High School diploma
Computer skills