Referral Specialist

• Collect comprehensive, detailed patient medical information and determine the need for nursing intervention
• Expedite care for urgent patients
• Interpret and apply policies and procedures
• Provide financial education regarding benefits and personal financial liability
• Obtain insurance verification and pre-certification
• Coordinate single case agreements and third-party payer contracts
• Schedule appointments and tests across departments, clinics, and private medical offices
• Coordinate medical information, records, and films for upcoming appointments
• Communicate patient status with internal and external providers
• Answer patient phone calls and address concerns and needs
• Capture accurate patient information for medical triage of spine referrals using Cordata and physician protocols
• Identify and process urgent patients and services requiring pre-certification or pre-authorization
• Obtain external medical records and transfer them to HIM and Cordata
• Enter demographic, billing, and insurance information into registration and billing systems
• Verify eligibility and benefits with insurance companies
• Advise patients, referring physicians, insurance companies, or providers about coverage issues and financial responsibility
• Obtain Workers Compensation authorization and document authorization details
• Refer WVU Cares/self-pay patients to financial counselors
• Schedule clinic appointments using Epic and communicate appointment details and instructions
• Flag patient accounts for special notifications and inform clinics of assistive-device needs
• Respond to and resolve patient and referring physician/office needs and complaints
• Record referral and physician information in Cordata and update the Referring Physician Database via Ruby-on-Line
• Identify duplicate Epic files and coordinate resolution with HIM
• Participate in performance improvement, educational programs, and departmental meetings

Referral Specialist – Spine Center

• Complete Level of Care Eligibility Tool (LOCET) assessments and other required evaluations
• Manage inbound and outbound calls professionally and empathetically
• Provide accurate referrals to non-Office of Aging and Adult Services (OAAS) community services
• Assess requestors’ needs
• Research available resources to meet requestors’ needs
• Connect individuals with essential services and resources

Information and Referral Specialist

• Answer phone calls to provide information and referral services, including intakes, screenings, and referrals
• Assess callers’ needs and determine the appropriate level of intervention
• Utilize the 211 resource database to provide and 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
• Perform other administrative tasks as assigned
• Support callers navigating health and human services, food sources, housing needs, government assistance programs, recovery supports, and related community resources

Information & Referral Specialist

• Report to the E-Referral Supervisor
• Monitor multiple e-referral systems to identify new referrals and manage alerts and notifications
• Monitor email requests to pull referrals from applicable referral systems
• Perform follow-up and manage related communication
• Scan documentation to determine patient eligibility for services, including service area, orders, and insurance
• Monitor the status of all referrals and follow up throughout the process
• Report referral status weekly
• Communicate with branch, sales, and leadership by email or phone regarding status updates and referral decisions
• Manage the ERST log daily with all referrals and ROCs decisions
• Maintain acceptable productivity levels according to work assignment and departmental standards
• Follow regulatory compliance areas, policies and procedures, and company best practices
• Serve as the initial contact point for clients or referral sources to promote continuity of care
• Collect and document referral information, manage compliance, and follow up on initial referral processes and decisions

E-Referral Specialist, Home Health

• Provide support to a clinical team to facilitate the administrative components of clinical referrals
• Act as a first-level subject matter expert beyond intake calls, including production-oriented work, physician assisting, and special projects
• Serve as a liaison between hospitals, health plans, physicians, patients, vendors, and other referral sources
• Review complex referrals for completeness and follow up for additional information
• Assign referrals to staff as appropriate
• Verify insurance coverage and obtain authorizations from insurance plans when needed
• Contact physician offices to obtain demographic information or related data
• Enter referrals and document communications, actions, and other data in the system
• Handle calls, texts, facsimiles, and electronic queues while taking notes and speaking with customers
• Perform other duties as assigned

Referral Specialist II

• Coordinate referral orders for specialty services and diagnostic testing within a multispecialty practice
• Schedule appointments for incoming referrals and communicate scheduling requirements to patients
• Coordinate scheduling and authorizations for pre-planned in-office procedures
• Act as liaison between patients, providers, departments, staff, specialty areas, and external referral sources
• Educate patients and families and assist with external resources when needed
• Determine CPT codes requiring authorization
• Verify insurance coverage, obtain payor authorizations, and communicate with receiving facilities and specialists
• Review provider schedules to ensure required referrals and authorizations are in place
• Track and manage referrals to close patient care gaps and document information for team awareness
• Maintain knowledge of medical terminology, ICD-10, CPT codes, insurance regulations, and payor requirements
• Maintain community resource lists and develop additional referral sources
• Train at Banner University Cancer Center until the new Scottsdale facility opens, anticipated in early 2027

• Build and manage a country-specific network of referring physicians across various therapeutic areas
• Identify and select physicians
• Provide physicians with training and support throughout the referral process
• Plan and conduct regular visits to referring physicians in person and/or via video conference
• Promote collaboration between referring physicians and study investigators
• Document key discussions and objectives in reports
• Provide ongoing support to referring physicians and their teams
• Ensure agreed-upon tasks are executed accurately and efficiently
• Collaborate with Clinical Operations, Regulatory, and Legal departments to implement the referral process across projects

• Build and manage a country-specific network of referring physicians across various therapeutic areas
• Ensure a smooth and effective referral process between referring physicians and study investigators
• Identify and select physicians
• Provide physicians with training and support throughout the referral process
• Plan and conduct regular visits to referring physicians in person and/or via video conference
• Document key discussions and objectives in reports
• Provide ongoing support to referring physicians and their teams
• Ensure agreed-upon tasks are executed accurately and efficiently
• Collaborate with Clinical Operations, Regulatory, and Legal departments to implement the referral process across projects

• Provide support to a clinical team to facilitate administrative components of clinical referrals
• Act as a first-level subject matter expert on intake calls, production-oriented work, physician assisting, and special projects
• Act as liaison between hospitals, health plans, physicians, patients, vendors, and other referral sources
• Review complex referrals for completeness and follow up for additional information
• Assign referrals to staff as appropriate
• Verify insurance coverage and obtain authorizations from insurance plans when needed
• Contact physician offices to obtain demographic information or related data
• Enter referrals and document communications, actions, and other data in the system
• Handle calls, texts, facsimiles, and electronic queues while simultaneously taking notes and speaking with customers
• Perform other duties as assigned

Referral Specialist II – Part-Time

• Serve as the first point of contact and primary contact for referrals initiated by medical professionals
• Build and maintain relationships with physicians and physician office representatives
• Create an expedited path for patients through financial, scheduling, and treatment phases
• Partner with Empowerment, Business Services, Finance, Clinical/Hospital Operations, Clinical Staff, and Physician Relations
• Manage the referral process
• Own engagement and referral growth for internal and contracted medical staff
• Manage a portfolio of physician contacts outside designated geographies activated by Physician Relations field staff
• Build and maintain referral relationships
• Drive physician satisfaction and referral growth