Referral Specialist

SCHS is a 90-100 employee, full-service, non-profit healthcare clinic serving the needs of the South Minneapolis community. Come make a difference in the lives of people every day while helping us achieve our mission: To improve the health of our patients and communities by delivering exceptional care, removing barriers, and promoting healthy lifestyles. Proof of full vaccination against COVID-19 is required.

ROLE: This individual assists patients and expedites the process of referral to external health care specialists.

JOB DUTIES:

· Ensure complete and accurate registration, including patient demographic and current insurance information.

• Advocate role on the patient behalf with the carrier to ensure approval of the necessary medical equipment/home care services for patients in a timely manner
• Cross trained with medical records and provide back up when needed

• Point of contract for patients having direct access for asking questions and raising concerns. Connecting patients to patient advocate, MNsure and Sliding Fee.
• Advocate role on the patient behalf with the carrier to ensure approval of the necessary medical supplies/ home care services for patients in a timely manner
• Manage SAGE SCOPE program; ensure paperwork is completed properly and sent out for claims processing. Maintain positive and effective relationship with SAGE staff.
• Coordinate with Medical records to ensure that all required records, imaging and/or procedural results are available to the external provider before the patient appointment.

· Assemble information concerning patient's clinical background and referral needs.

· Per referral guidelines, provide appropriate clinical information/records to the medical specialist the patient is being referred to.

· Contact review organizations and insurance companies to ensure prior approval requirements are met, in order to ensure payment for services; present necessary medical information such as history, diagnosis and prognosis.

· Review details and expectations about the referral with patients; inform patient regarding what documentation they should provide at appointment.

· Assist patients in problem solving potential issues related to the health care system; request interpreters as appropriate, assist with access to transportation services.

· Ensure that referrals are addressed in a timely manner.

· Manage internal urgent vision referrals by contacting patients via phone to schedule appointments.

· Assist with community health worker services referrals.

· Inform patients of scheduled appointments with external specialist via mail, phone or care message (text).

· Enter ultrasound orders and patient demographic information in Lattice Pro for upcoming appointments.

· Maintain ongoing tracking and appropriate documentation on referrals to ensure quality of patient care and outcomes; follow up with providers and/or patients about missed appointments.

• Attend and participate in staff meetings and committees.

· Assist with other duties and responsibilities as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

· Confidence, professional judgment, and grace under pressure.

· Works well both independently and as part of a team.

· Exceptional verbal and written communication skills.

· Flexibility--nimble in response to an evolving workload.

· Ability to exhibit good rapport with clients of varying ethnic backgrounds and socio-economic status.

· Excellent time management and organizational skills.

· Attention to detail; ability to prioritize.

· Commitment to the SCHS mission and staff values.

MINIMUM QUALIFICATIONS:

· High school diploma.

· Medical Assistant experience or knowledge of medical termination desired.

· PPX (lattice pro entry) experience a plus.

· Bilingual (English/Spanish) required.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Language:

• Spanish (Required)

Work Location: One location