Referral Specialist

Title: Referral Specialist Reports To: Lead Referral Specialist Direct Reports: None Classification/Category: Admin Level I Workgroup(s) : None Work Status : On Site Status: Non-Exempt Summary of Position The Referral Specialist is responsible for establishing and maintaining a patient referral system for the center. This shall include scheduling appointments, ensuring that appropriate paperwork is sent to the consulting clinician, obtaining approval from insurance companies, notifying the patient regarding the arrangements that have been made and maintaining adequate referral form inventories.

The Referral Specialist will model behaviors consistent with the published values and the Code of Conduct of RCCHC. RCCHC Mission, Vision and Values Mission : Great care for every one every day. Vision : Striving to be the primary healthcare provider, dedicated to and supported by the people we serve. Values : ( R )espectful, ( C )ompassionate, ( C )aring, ( H )onest, ( C )omitted Population Served Roanoke Chowan Community Health Center will provide open access, community-oriented primary care of the highest quality to all residents within our service area and surrounding counties, regardless of their ability to pay.

Minimum Qualifications

Computer skills required Works effectively with others and is able to organize workload, as well as assume responsibility and maintain confidentiality Must be able to work independently, exercise appropriate decision-making skills, and function effectively on a team. Must be able to speak and communicate clearly and effectively Education : Graduate of an accredited high school or business school Experience : Work experience in a business or medical practice preferred Certification(s)/Licensure : N/A Knowledge: Knowledge and thorough understanding of Federally Qualified Health Centers (FQHC’s) in regard to the Federal 330 Public Health Service Act Knowledge of thorough understanding of the 340B program Knowledge of computer systems and applications.

Skills: Skill in exercising a high degree of initiative, judgment, and discretion. Skill in analyzing situations accurately and taking effective action. Skill in establishing and maintaining effective working relationships with the medical and administrative staff, patients and the community. Skill in planning, organizing, and prioritizing work; delegating and achieving goals and objectives.

Skill in exercising judgment and discretion in developing, interpreting, and implementing departmental policies and procedures. Skill in identifying and resolving problems. Skill in developing comprehensive reports. Abilities: Ability to plan, organize, and integrate priorities and deadlines. Ability to identify, analyze, and interpret complex data and, resolve operational problems.

Ability to evaluate and make recommendations for continuous quality improvement. Ability to evaluate and make recommendations for continuous risk assessment. Ability to anticipate and react calmly in emergency situations. Ability to communicate clearly and effectively orally and in writing. Ability to competently use Microsoft Office, including Word, PowerPoint, Excel, and appropriate organizational software.

Essential Functions

Schedules referral appointments and contacts patients with a reminder of appointment Ensures appropriate paperwork is sent to the consulting clinician Maintains a tracking log of referred patients Assists insurance companies with additional information such as pre-existing conditions, diagnosis, coverage, etc. Acts as referral liaison between RCCHC and other healthcare facilities Sets authorization for MRI and CT Ensures scheduling adheres to standardized protocol Participate as an active member of the RCCHC team Maintain compliance with workflows, policies and procedures as well as other activities to support PCMH model of care and accreditation Other job duties may be required that are not listed above.