Referral Specialist - Full Time - Waimea

This Referral Specialist is responsible for managing and coordinating specialty referrals, test orders, prior authorizations and is responsible for the necessary follow-up for the patient in collaboration with the provider in relation to these activities. This individual must be capable of appropriately prioritizing and organizing tasks related to patient care. The Referral Specialist must poses the ability to concentrate, listen, problem solve, and communicate effectively and must demonstrate excellent customer service skills consistently. The Referral Specialist is expected to support the Center’s mission and values and adhere to HKH policies and procedures, as well as applicable state and federal regulations. The Referral Specialist is expected to consistently demonstrate excellent interpersonal skills, teamwork and customer service skills and act in a supportive role as part of the patient care team.

The following duties are typical for the Referral Specialist. Incumbents may not perform all of the listed duties and/or may be required to perform additional or different duties from those set forth below to address business needs and changing business practices.

• Prioritize patient care and manage patient flow for maximum efficiency and optimum care delivery.
• Coordinate referrals, imaging orders, and pre-authorizations and follow-up with appropriate internal and external resources.
• Maintain HKH referral tracking system for referrals and test orders to external and internal resources.
• Facilitate process for quality specialty medical diagnostic and therapeutic services to be available to patients.
• Maintain appropriate documentation, both written and electronic, within scope of practice.
• Communicate accurate and pertinent information with patients and other family members to facilitate appropriate, effective and efficient patient care.
• Communicate accurately and effectively with providers and other staff members of the patient care team in a consistent manner.
• Maintain a safe, clean, and confidential working environment consistent with OSHA, HIPAA and HKH standards and regulations on a consistent basis.
• Comply with all HIPAA regulations on a consistent basis.
• Recognize and take action on potentially unsafe acts and condition.
• Participate in quality improvement and risk management programs.
• Represents HKH positively in the community.
• Perform all other duties as assigned and required.

EDUCATION, EXPERIENCE & QUALIFICATION GUIDELINES

Any combination of education and experience that would likely provide the required knowledge and abilities is qualifying.

• High School Graduate or GED equivalent
• Two years of related clinical office experience.
• One year of medical records management experience.
• Familiarity with QUEST and other insurance programs.
• Familiarity with Hawaii health care networks Knowledge of ICD-9 and CPT coding.
• Demonstrated proficiency with basic computer systems.
• Demonstrated proficiency in operation of multi-line phone systems.
• Demonstrated ability working effectively with electronic and paper medical records.
• Familiar with basic Medical terminology.
• Ability to communicate effectively in written, electronic and oral form.
• Ability to interact appropriately and effectively with a wide variety of ages and cultures.
• Demonstrated ability to work effectively as a team member.
• Demonstrate excellent organizational capabilities.

• Demonstrate proficient utilization of Electronic Medical Record system.
• Coordinate and facilitate process for specialty referrals and preauthorization requirements and follow-up with appropriate internal and external resources to ensure a high level of customer service and satisfaction.
• Develop and maintain tracking system for referrals to outside resources. Demonstrate competency in managed care follow-up.
• Maintain appropriate documentation, both written and electronic, within scope of practice. Demonstrate excellent customer service interactions consistently, utilizing a cheerful and engaging service-oriented demeanor.
• Communicate accurate and pertinent information with patients, and other family members to facilitate appropriate, effective and efficient patient care.
• Communicate accurately and effectively with providers and other members of the care delivery team in a consistent manner.
• Maintain a safe, clean, and confidential working environment consistent with OSHA, HIPAA and HKH standards and regulations on a consistent basis.
• Demonstrate the ability to operate business machines including: copiers, fax machines, and computers.
• Represents Hamakua-Kohala Health positively in the community. Effectively manage changes in work demand during work day. Recognize and take action on potentially unsafe acts and conditions.
• Actively participate in quality improvement and risk management programs. Participate as an active, supportive team member on the patient care team. All other duties as assigned.
• Courteous, honest and professional at all times.
• Able to communicate and relate well with physicians, clinical support staff and other HKH employees.
• Able to provide innovative input into the development of the clinic and its processes.
• Efficient, organized and accurate.