Referral Specialist

πŸ”₯ 9 minutes ago

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Orchid Health

51 - 200 employees

Orchid Health was founded on the idea that rural communities deserve access to high-quality healthcare services. It’s simply unacceptable that tens of thousands of rural Oregonians still aren’t offered a fair chance at personal stability and advancement due to a lack of healthcare and healthcare education.

πŸ“‹ Description

β€’ Ensure appropriate appointments and follow-up appointments in the clinic following referral requests/visits. β€’ Ensure documentation from specialists/offices is obtained, filed in the chart and forwarded to companies/payers as appropriate. β€’ Perform patient registration tasks and procedures as requested as well as assist in the clinical area as trained and requested. β€’ Initiate all referral requests within 24-48 hours on business days. β€’ Return all calls promptly generally within the same day. β€’ Document all stages of the referral process within the EMR program (Athena) and communicate to the appropriate people regarding injury cases. β€’ Coordinate and schedule specialty exams within the clinic as necessary. β€’ Obtain and/or document approvals from Third-Party Payers for payment for services as directed or indicated via protocols. β€’ Answer phone calls and act as a liaison between companies, patients, attorneys and work comp insurance companies. β€’ Request any missing documentation from providers, once received and signed off by the medical director, scan appropriate information into the EMR program (Athena). β€’ Resolves pre-certification, registration and case-related concerns prior to a patient's appointment. β€’ Gather pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided. β€’ Use the EHR (Athena) to monitor referral orders and document all referral activities in the EHR. β€’ Complete prior authorizations when needed. β€’ Complete appropriate referral forms. β€’ Consult with providers regarding specific diagnosis information, as it relates to the referral. β€’ Comply with federal, state and local regulations regarding patient confidentiality and HIPAA. β€’ Ensure that the patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. β€’ Perform other job-related duties, as may be assigned.

🎯 Requirements

β€’ High school diploma or GED certificate. β€’ Minimum of 1 year relevant healthcare experience. β€’ Proficient at Excel, Word, and Outlook. β€’ Excellent communication and problem-solving skills. β€’ Excellent interpersonal skills, empathy and tact, when dealing with insurance companies, patients and other health care facilities. β€’ Able to assume the responsibilities delegated by the Manager, to provide efficient and effective coordination of care. β€’ Willing to adapt to changing situations and circumstances. β€’ Preferred Qualifications: Bilingual in Spanish. Athena experience. Knowledge of medical terminology

πŸ–οΈ Benefits

β€’ Medical, Dental, & Vision – Orchid pays monthly premiums at 100% for team members and at least 50% for their dependents for base medical and dental plans β€’ $1,000/year Wellness Benefit - for things that make you happy! β€’ 401(k) with a company match and financial planning and wellness resources available at no cost. β€’ A Continuing Education / Continuing Medical Education budget for all team members β€’ An Employee Assistance Program (EAP) that provides mental health support, financial planning, and lifestyle training opportunities, at no cost to employees β€’ 128 hours of PTO per year, annually front-loaded with tenure-based increases β€’ 40 hours of paid inclement weather and emergency closure leave, annually front-loaded β€’ 8 paid holidays, plus your birthday off! β€’ Free care at our clinics for team members and their families β€’ And more!

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