Patient Referral Representative (Finance)

Description

At Signature Health, our purpose is to provide integrated healthcare for our community specializing in patients with mental illness and/or addiction because we want people to realize their highest potential. If you align with our core values, putting people first, striving for excellence in the work you do each day and have a can do mindset, then Signature Health is the best place for the next step in your rewarding career. As a full-time employee, you will have access to the following employer/employee paid benefits:

• Medical, Dental, Vision, 401k match, HealthJoy - a no cost medical and mental health online resource available Day 1, and much more
• Robust earned paid time off program (PTO)
• Federal Loan Forgiveness Program (available on eligible roles)
• Tuition & Professional Development Assistance

SCOPE OF ROLE:

Reporting to the Supervisor, Patient Referrals the Patient Referral Representative will be successful in their role by providing an exceptional experience for Signature Health clients and patients. You will oversee the referral life cycle of patient outreach. The Patient Referral Representative will act as a subject matter expert in the components of access management, referral reports, scheduling, and insurance verification.

HOW YOU'LL SUCCEED:

• Act as primary interface between patients, providers, referral sources and Signature Health departments for referrals.
• Conduct inbound/outbound calls with prospective patients, external referral sources, community providers and Signature Health team members to ensure the efficient scheduling of appointments.
• Generate working referral reports, scheduling, insurance verification and overall questions regarding Signature Health services and locations.
• Demonstrate an understanding of Signature Health's Electronic Health Record (EHR) applications and partner with IT and the operations team to stay current on workflows and technical capabilities ensuring content is up to date.
• Plan, assess and improve referral operations as identified; implement improvements through consultation, staff development and systems improvements.
• Create a friendly and positive work environment when maintaining ongoing communication by working with key stakeholders throughout Signature Health.
• Review, edit, and maintain financial referral procedure documentation.
• Proactively screen clients and patients with scheduled appointments to assess need for authorizations, collect past due balances, problems with claims, or benefit eligibility.
• Educate clients and patients with information regarding insurance, benefit, and financial policies and procedures impacting care delivery.
• Participate in all Quality Assurance and Utilization Review activities.
• Comply with all agency policies and procedures.
• Maintain all aspects of HIPAA, promoting patient confidentiality and right to privacy.
• May be required to perform remote services as determined by Signature Health.
• Adherence and completion of compliance training provided by Signature Health.
• Responsible for and completes all productivity/documentation requirements.
• Participate in all assigned staff meetings and staff development programs.
• Demonstrate appropriate attendance and punctuality in adherence with Signature Health policies.
• Other duties as assigned.

Requirements

KNOWLEDGE & EXPERIENCE:

• High School Diploma or equivalent required.
• 1 year office, customer service, or related experience required. Medical office experience preferred.
• Previous demonstrated experience in healthcare with referrals, health insurance, quality assurance and troubleshooting experience preferred.
• Medical Terminology preferred.
• Knowledge of commercial and government funded healthcare programs preferred.
• Experience working with an EHR system required; EPIC experience preferred.
• Demonstrated proficiency with Microsoft Office, Word, and Excel.
• Fluency in writing and speaking Spanish preferred.

WORKING CONDITIONS:

• Work is normally performed in a typical interior/office/clinical work environment.
• While hours of operation are generally standard, flexibility to work evenings and extended hours may be required.
• Requires periods of sitting, standing, telephone, and computer work.
• Hearing: adequate to hear clients or patients in person, over the telephone or through telehealth technology.
• Speaking: adequate to speak to clients or patients in person, over the telephone or through telehealth technology.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
• Physical effort required: occasional lifting and carrying items weighing up to 15 pounds, unassisted.
• Possible exposure to blood borne pathogens while performing job duties.
• Frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted regularly throughout a regular workday.
• Sufficient dexterity to operate a PC and other office equipment.

This Success Profile is not an exhaustive list of all functions or requirements that you may be required to perform; you may be required to perform other job-related assignments as requested by your supervisor or the company. You must be able to perform the essential functions of the position satisfactorily; however, if requested, reasonable accommodations may be made to enable you to perform the essential functions of this job, absent undue hardship. Signature Health may revise this Success Profile at any time, with or without advanced notice.

All employees of Signature Health are required to comply with the Signature Health Annual Influenza Vaccination Policy. This policy requires employees to obtain an annual flu vaccination. A medical and/or religious exemption may be submitted for review by the Signature Health Review Committee. Exemption requests are not guaranteed to be approved. Signature Health is a drug-free workplace. After receiving a conditional job offer, all applicants must successfully pass a pre-employment drug screen.