Referral Spec-Team Leader-PT Admin Por Admitting

Summary The Referral Specialist, Team Leader provides leadership and oversight to the referral specialists. This person will be responsible to insure a complete, accurate and timely referral process while maintaining excellence in delivering positiverelationships with healthcare providers and the community. The Referral Specialist, Team Leader supports transitions to care and maintains a patient advocacy role for ensuring access to care or other community services. This position serves as the front line of the agency for referral sources and patients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and/or ability required. All agency personnel must successfully complete a post-offer pre-placement assessment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and Experience Bachelor's level with concentration in business or communication with a minimum of one to two years of work experience in a healthcare setting. Solid training in an environment that emphasizes the importance of positive customer service skills is very desirable. Acceptable Equivalence to Education and Experience High school graduate or equivalent with more than three years of proven work experience in the health care field as a support staff person Supervisory Responsibility Referral Specialists Certificates, Licenses, Registrations * Current, valid driver's license to operate a motor vehicle, with vehicle available for work covered by liability insurance as specified by agency policy. Esse ntial Functions 1. Provides direction, instructions and guidance to the referral specialists to ensure successful completion of tasks. 2. Ensures Referral Specialist maintain excellence in verbal and written communications to provider sources. 3. Maintains schedule for coverage to ensure adequate capacity to process all referrals in a timely manner. 4. Models excellence in customer service and maintains an advocacy role in facilitating referrals to Agency. 5. Ensures complete and accurate registration, including patient demographic and current insurance information for referred patients. 6. Contacts payor sources to ensure prior approval requirements are met. Present necessary medical information. Verifies non-Medicare insurance policies and Medicare secondary payers when applicable. Communicates results to clinicians to maximize referral coordination and planning. Secures initial and follow-up authorizations for managed care, private insurance, and state funded programs with support of clinician as necessary. 7. Reviews details and expectations about the referral with patients. 8. Assists patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance). 9. Ensures that referrals are processed in a timely manner. 10. Performs welcome calls to patients via phone. 11. Enters information into the EPIC system from physician office referrals using faxed paperwork. Enters medications into the EPIC system as supplied by the referring physicians. 12. Documents, verifies, and maintains current insurance (including contacts and phone numbers) and benefits in computer system, creates an electronic notation to alert the visiting staff of insurance information and indicates the need for clinical staff to follow up as appropriate. Company Description:About MaineHealth As Maine s largest employer, MaineHealth offers truly rewarding careers for those who share our commitment to delivering advanced, innovative care with profound compassion. Northern New England is a beautiful and diverse place, a place of breathtaking scenery and wonderful people. We re proud to call this home and honored to help ensure that our communities our families, our friends, our neighbors are the healthiest in America. We seek skilled, committed professionals to help define and deliver quality, compassionate care. If that s you, we invite you to take the first step on a career journey of professional advancement and personal fulfillment.MaineHealth is ranked among the nation's top 100 integrated healthcare delivery networks. MaineHealth member organizations include:Franklin Community Health NetworkLincolnHealthMaine Behavioral HealthcareMaine Medical CenterMaineHealth Care at HomeMemorial HospitalNorDxPen Bay Medical CenterSouthern Maine Health CareSynernetWaldo County General HospitalWestern Maine HealthAffiliates of MaineHealth include:MaineGeneral HealthMid Coast-Parkview HealthNew England Rehabilitation Hospital of PortlandSt. Mary s Health System