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Brown University Health

Referral Specialist

Brown University Health, East Providence, Rhode Island, us, 02914

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Referral Specialist – Brown University Health

Summary: The Referral Coordinator reports to the Prior Authorization Supervisor. Under general supervision, coordinates patient flow regarding pre-registration scheduling appointments with specialists and testing per physician request. Obtains proper insurance authorization prior to scheduling and informs the patient with pertinent information. Ensures all required information is forwarded to the specialist office following practice protocols. Acts as a liaison between the hospital and patients to resolve financial issues related to outpatient registration. Coordinates effective processing and scheduling of all incoming referrals, adhering to established timelines and departmental procedures. Brown University Health employees are expected to model the organization’s values of Compassion, Accountability, Respect, and Excellence, and demonstrate core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

Responsibilities

Preregister, schedule, coordinate, and triage all referrals created by and sent to the practice via Lifechart workqueues.

Set follow-up alarms per practice protocols to ensure all outstanding referrals are followed up.

Monitor and update pre- and post-registration workqueues.

Obtain all un-resulted consults and testing orders managed by the referral office.

Alert the ordering provider of patients who miss an appointment with a specialist or testing facility.

Receive and review all incoming referrals for completeness and accuracy, including demographics, insurance, and authorizations.

Communicate with referring providers and/or patients regarding insurance coverage issues to facilitate timely services.

Maintain current knowledge of insurer referral/authorization requirements; demonstrate cultural awareness and sensitivity.

Document communications in the EHR with referring providers, patients, and Clinic staff.

Collaborate with Social Work, Patient Financial Advocate, and Patient Navigator for Financial Assistance and eligibility.

Participate in practice performance and quality improvement activities; attend required meetings and trainings; perform other related duties as assigned.

Monitor clinic schedules to maximize scheduling efficiency and fill available timeslots, including cancellations/reschedules.

Notify Provider and/or Supervisor if unable to schedule a referral or if there are access issues.

Monitor referral work queues to ensure all referrals are processed appropriately.

Apply knowledge of front office operations and clinical triage to determine when a patient needs to be seen.

Minimum Qualifications

High school degree or equivalent; billing and medical knowledge preferred.

Two years of clinical referral experience preferred.

Data entry skills and computer experience required.

Strong customer service focus; effective verbal and written communication skills.

Organized with the ability to manage competing priorities and follow through with delegated tasks.

Demonstrated knowledge to provide care across the lifespan with cultural sensitivity.

Performs independently within department policies and practices; refers complex problems to the physician practice manager as needed.

Compensation and Benefits

Pay Range: $17.00 - $25.82

Equal Employment Opportunity: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from unlawful discrimination and harassment.

Location: East Providence, 375 Wampanoag Trail, East Providence, RI 02915

Work Type: 8:00 AM – 4:30 PM

Work Shift: Day

Daily Hours: 8 hours

Driving Required: Yes

Job Details

Seniority level: Entry level

Employment type: Part-time

Job function: Health Care Provider

Industries: Hospitals and Health Care

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