Referral Specialist

• Serve as the primary contact for referral sources, patients, and associated field-based sales representatives
• Navigate new prescriptions through referral, service determination, and pharmacy management processes
• Build and maintain relationships with referral-source personnel
• Follow up with referral sources, patients, and caregivers to collect demographic, benefits, clinical, and prescription information
• Communicate benefit investigation outcomes, patient costs, financial responsibility, and assistance options
• Coordinate with Nurse Coordination for in-home nursing, prescription fulfillment, and shipping
• Coordinate with Pharmacy Operations to support patient onboarding and ongoing fulfillment
• Document provider, patient, caregiver, and field-team updates in systems of record
• Track referral turnaround time, volume, workload metrics, and completion goals
• Communicate referral status, outcomes, and next steps to stakeholders
• Participate in quality assurance activities, audits, meetings, presentations, and related administrative duties

Referral Specialist coordinating infusion prescriptions and patient access for LUX Infusion

Referral Specialist coordinating patient referrals and prescriptions for LUX Infusion, a U.S.-based infusion-care provider.
Managing service determination, benefits information, nursing coordination, pharmacy fulfillment, and stakeholder communications.

• Coordinates referral orders for specialty services and diagnostic testing within a primary care practice.
• Provides all pertinent clinical information needed for the payor authorization and the facility or specialist prior to the services being rendered.
• Acts as a liaison between the patient and the specialty area by navigating the appointment process.
• Ensures that proper authorization(s) are obtained for appointments to provide a seamless experience for patients.
• Tracks and manages all referrals with the intention to close any patient care gaps and provides documentation to promote team awareness.

Referral Specialist coordinating patient treatments in a multi-specialty practice

Ambulatory Referral Specialist

Referral Specialist coordinating patient referral orders and ensuring proper authorization for specialty services. Working within a multi-specialty practice to provide essential patient care support.

• Initiates and manages clinical referrals for pre-authorization
• Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources
• Reviews referrals for completeness and follows up for additional information if necessary
• Assigns escalated referrals to staff as appropriate
• Verifies insurance coverage and completes pre-authorization process for imaging exams
• Responds to inbound calls initiating exam requests
• Contacts physician offices as needed to obtain demographic information or related data
• Enters referrals, documents communications and actions in system

Referral Specialist I facilitating clinical referrals for Elevance Health

Referral Specialist I facilitating clinical referrals and managing communication between healthcare providers for Elevance Health. Ensuring proper processing and documentation of insurance authorizations in a remote and hybrid work environment.

• Answer phone calls to provide information/referral services, including intakes, screenings, and referrals
• Assess callers’ needs and determine the appropriate level of intervention
• Utilize the 211 resource database to provide/record information about accessing social services
• Assist callers who speak different languages by utilizing the Language Line
• Participate in group discussions, team meetings, and trainings to build skills and strengthen team connections
• Other administrative tasks as assigned

211 Info & Referral Specialist handling calls for Granite United Way

Part-Time – 211 Info & Referral Specialist

211 Info & Referral Specialist providing information and referrals for Granite United Way. Assessing caller needs and connecting them to local services in a hybrid environment.

• Coordinating referral orders for treatment continuation
• Scheduling appointments for specialty services and diagnostic testing
• Acting as a liaison between patients, providers, and staff members
• Providing all pertinent clinical information for the payor authorization
• Tracking and managing all referrals
• Collaborating with outside referral sources and community resources

Referral Specialist coordinating patient care in healthcare settings

Referral Specialist, Neurosurgery

Referral Specialist coordinating patient care and treatment within a busy healthcare environment. Ensuring seamless patient referrals and appointment scheduling for specialty services and diagnostics.

• Monitor multiple e-referral systems to identify new referrals and manage alerts and notifications.
• Monitor email for request to pull referrals from all applicable referral systems.
• Perform follow-up and manage all related communication.
• Scan documentation to determine patient eligibility for services (service area, orders, insurance, etc.)
• Monitor status of all referrals received, follow up with each throughout process, reports on status weekly.
• Communicate with branch, sales, leadership by email or phone for status updates and referral decisions.
• Daily management of ERST log with all referrals and ROCs decisions.
• Maintain acceptable productivity level, as determined by work assignment and departmental standards.
• Comply with and follow all regulatory compliance areas, policies & procedures, and company best practices.

E-Referral Specialist monitoring referral processes and ensuring eligibility for home health services

E-Referral Specialist, Home Health

E-Referral Specialist evaluating and processing referrals within a home health context. Ensuring compliance and communication with various stakeholders while managing data documentation.

• Work with patients requiring a referral to ensure needs are fulfilled
• Process referrals, authorizations, and pre-certifications for timely reimbursement
• Schedule appointments and coordinate clinic visits
• Communicate information and answer patients' questions regarding health care plans
• Enter referrals and document actions into the system
• Notify physicians and patients when referrals are denied

Referral Specialist ensuring patient referral needs are fulfilled in healthcare setting

Referral Specialist ensuring patient referral needs are fulfilled for specialty services. Processing referrals and coordinating clinic visits at MercyOne Central Iowa healthcare system.

• Schedules appointments for specialty physician services and diagnostic testing per provider request and communicates with the patient on a timely basis for all scheduling requirements
• Acts as a liaison between patients, providers and staff members for patients’ referral and follow up needs
• Provides all pertinent clinical information needed for the payor authorization, the facility or specialist prior to the services being rendered
• Tracks and manages all referrals by monitoring outstanding referrals at 30/60/90 day intervals
• Applies knowledge of medical terminology and maintains up to date knowledge of insurance environment
• Collaborates with outside referral sources and other community resources

Referral Specialist coordinating patient referrals and diagnostic testing in healthcare

Referral Specialist – Multispecialty

Referral Specialist coordinating patient referrals and diagnostic testing in healthcare setting. Engaging with patients and providers to ensure seamless continuity of care.

• Respond to community members via phone, chat, email, and text on the Washington 211 line
• Assess needs, provide tailored referrals, and connect people to vital resources like housing, food, healthcare, and financial assistance
• Document interactions accurately and maintain detailed records
• Navigate a comprehensive resource database while delivering compassionate, high-quality service
• Contribute to a collaborative, mission-driven contact center environment

Information & Referral Specialist assisting community members on the Washington 211 line

Information and Referral Specialist

Information & Referral Specialist connected to Crisis Connections, assisting community members via phone, chat, and email. Helping individuals navigate essential services and resources during critical moments.

• Provide exceptional customer service to patients
• Facilitate the transfer of care between primary care providers and specialists
• Collaborate with multiple clinics to utilize resources
• Navigate and negotiate tracking and coordination of referrals
• Ensure accurate collection of patient information
• Support all clinic departments in referral processes
• Contact insurance companies for prior approval requirements

Healthcare Resource Specialist providing service in Boise, Idaho

Healthcare Resource Specialist, Referral Team

Healthcare Resource Specialist facilitating patient care and referrals in Boise, Idaho. Collaborating with clinics and insurance companies to ensure quality healthcare services.

• Takes inbound calls from individuals needing support, services, or who may be in crisis
• Performs safety screenings and assessments to discern presence and acuity of risk to the safety of the individual or others
• Uses information provided by the caller and obtained during the screenings and assessments to accurately understand the individual's needs and develop a plan of action in collaboration with the individual
• Completes appropriate, timely, and accurate documentation of interactions in accordance with established criteria
• Provides linkage follow-up as directed to assure individual accessed services
• Coordinates with other agencies, organizations and individuals to insure optimal use of resources, services and natural support systems
• Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations

Crisis & Referral Specialist managing inbound calls for behavioral health support

Crisis & Referral Specialist

Crisis & Referral Specialist managing inbound calls for behavioral health support. Screening and assessing risks while coordinating services and compliance with regulations.

• Takes inbound calls from individuals needing support, services, or who may be in crisis
• Performs safety screenings and assessments to discern presence and acuity of risk to the safety of the individual or others
• Develops a plan of action in collaboration with the individual
• Completes appropriate, timely, and accurate documentation of interactions
• Provides linkage follow-up as directed
• Coordinates with other agencies and organizations
• Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations

Crisis & Referral Specialist providing telephonic intervention at Elevance Health

Crisis & Referral Specialist providing telephonic support and assessments for helpline callers at Elevance Health. Operates within 24-hour call center to assist individuals in crisis.

• Takes inbound calls, texts and chats from individuals needing support, services, or who may be in crisis
• Performs safety screenings and assessments to discern presence and acuity of risk to the safety of the individual or others
• Uses information provided by the caller and obtained during the screenings and assessments to accurately understand the individual's needs and develop a plan of action in collaboration with the individual
• Completes appropriate, timely, and accurate documentation of interactions in accordance with established criteria
• Provides linkage follow-up as directed to assure individual accessed services
• Coordinates with other agencies, organizations and individuals to ensure optimal use of resources, services and natural support systems
• Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations

Crisis & Referral Specialist providing telephonic intervention/de-escalation support

Crisis & Referral Specialist screening and supporting individuals in crisis via telephonic intervention. Collaborating with organizations and ensuring compliance with safety regulations while providing essential services.

Referral Specialist jobs in United States

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Referral Specialist

Ambulatory Referral Specialist

Referral Specialist

Part-Time – 211 Info & Referral Specialist

Referral Specialist, Neurosurgery

E-Referral Specialist, Home Health

Referral Specialist

Referral Specialist – Multispecialty

Information and Referral Specialist

Healthcare Resource Specialist, Referral Team

Crisis & Referral Specialist

Crisis & Referral Specialist

Crisis & Referral Specialist