PruittHealth

Community Manager

• Manage all incoming referrals from a selection of key referral sources.
• Evaluate referrals for admission to PruittHealth leveraging clinical experience and an understanding of Home Health agencies.
• Engage with partners across disciplines, from external hospitals and healthcare systems to Pruitt administrators, clinical managers, and Community Relations Representatives.
• Review patient referrals and respond on behalf of PruittHealth meeting productivity response expectations.
• Accurately completes referral documentation as necessary to facilitate the admissions process.
• Manages incoming calls and responds before the third ring.
• Assigns the appropriate next person in the referral management process.
• Verifies insurance and eligibility if assigned.
• Works closely with clinical team until admission is scheduled.
• Attends morning huddle calls.
• Collaborates with revenue cycle team to ensure understanding of payors and requirements affecting verification/authorization.
• Escalate issues or barriers to manager.
• Reviews physician orders and follows up with referral source for clarifications or additional information if needed.
• Identifies objections, concerns, or other entry barriers and provides information in response to address those issues.
• Processes and documents referrals that are not accepted for admission, indicating specific reason for non-acceptance.
• Access multiple electronic health systems to receive referrals.
• Understand daily agency statuses across staffing, payor, and clinical abilities and manage points of contact across assigned agencies.
• Partner closely with sales partners, admins, and clinical managers.
• Support further processing referrals, vet payors, and conduct welcome calls when needed.
• Perform other related duties as necessary and as directed by supervisor.

Community Referral Specialist