Referral Specialist - Damien Center
- 18-Apr-2021 to 17-May-2021
- - Damien Center
- Indianapolis, IN, USA
- Full Time
- Complete Benefits Package Available
Damien Cares Clinic Team
Damien Center empowers communities and persons affected by HIV/AIDS in the state of Indiana by being a leading resource, provider, and advocate for comprehensive HIV/AIDS care, prevention, education, and related services. Damien Center, Damien Cares and Damien Pharmacy provide client-centered social services focused on care coordination, clinical and pharmacy services, mental health, housing, and nutrition to the Indianapolis community.
The Referral Specialist ensures that patients are effectively assessed and referred to specialty office referral visits. This position resolves pre-certification, registration, and patient concerns prior to patient visit. The Referral Specialist documents pertinent information from insurance carriers, financial representatives, and other relevant parties to assure patient financial obligations are met for services provided. This position collects and documents all referral prescriptions to assure 340B income is collected and ensures that the administrative functions related to referrals are completed effectively.
Duties and Responsibilities:
This job description describes the general nature and level of work performed by employees assigned to this position. It should not be construed as an exhaustive list of all required duties, responsibilities, and skills.
- Acts as a liaison between Damien Cares and its patients with hospitals, medical practices, physicians, vendors, and other referral sources.
- Assesses and refers patients to external specialty office visits as appropriate and directed by medical providers.
- Schedules outpatient and inpatient procedures as needed and communicates necessary prep information, collection of co-pays and deductibles, and pre-registration to patients.
- Verifies insurance, ensures appropriate pre-authorizations are secured, and resolves patient concerns as they occur.
- Documents referrals, communications about referrals, and needed follow up in the Electronic Medical Record system and communicates updates to providers.
- Counsels patients in the office, and over the telephone, regarding the referral requirements of their insurance carrier.
- Assures medical records are captured from all referrals, including medical notes, medications prescribed, and follow up expectations.
- Coordinates with 340B internal staff to capture benefits for all eligible prescriptions, track commonly used pharmacies, and avoid diversionary claims.
- Creates reports regarding referral prescriptions related to common pharmacies used and coordinates to assure appropriate locations are listed as contract pharmacies within the 340B program.
- Audits all referral prescriptions to assure eligibility within the 340B program.
- Performs special assignments and other work, on an as-needed basis.
Education and/or Experience
Bachelor's degree preferred, but not required. Experience with Medicare/ Medicaid and commercial Insurance preferred. Experience working in a medical setting preferred. Bilingual in Spanish/ English a plus.
Work experience may substitute for education requirements on a case-by-case basis.
Knowledge, Skills, and Abilities:
Possess superior organizational and administrative skills. Excellent interpersonal and communication abilities. Excellent computer skills in a Microsoft Windows environment. Ability to work independently and achieve high standards of productivity, achieving deadlines and with superior product results. Strong calendaring, organizational, and document management skills required. Proactive approach to solving problems and communicating to leadership. Knowledge of office management systems, procedures, and office equipment required. Excellent time management skills and ability to prioritize work.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily. The requirements listed are representative of the basic knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual in this role must display the highest level of integrity and confidentiality. The individual should have effective communication skills, attention to detail and organization, and flexibility and adaptability. The individual will also maintain knowledge of trends in their area of responsibility.
The physical demands described here are general representations of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit, reach with hands and arms, talk, and hear. The employee frequently is required to use hands to touch and handle objects. The employee frequently stands or walks.
- The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office setting, with sustained use of a computer.
- The noise level in the work environment is minimal to moderate.
- Maintains personal/professional competency and works to create an environment of courtesy, respect, enthusiasm, and a positive attitude in all interactions both internal and external to the organization.
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