CRO - Health Referral Specialist
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Provides customers access to health information such as health system services, physicians referrals, appointments, class and screening registration, and any other information they may request. Directly supports internal physician referral process through various EMR databases to include documentation, insurance verification, and scheduling. Utilizes designated software to document customer related information and services as requested by the customer or physician. Integrates customer service with various types of telephonic and electronic tools to ensure a positive patient experience.
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Minimum of 2 years College/Vocational education - Required
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1-2 Years - Required
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Minimum of 18 months previous experience working in an office setting as a telephone customer service representative, telemarketing representative or health care representative required. Patient care experience preferred. Due to job responsibilities, the CRO Health Referral Specialist must be proficient with computers and telecommunications software and other technologies, including but not limited to experience with Microsoft Outlook, Excel, Word, Windows operating system. Database and word processing experience preferred. Meditech, call center software and other EMR experience a plus.
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- Follows steps as outlined in policies to process referrals, appointments with specialists, ancillary services and any other referral as ordered by the physician/provider with any approved EMR databases. Documents physician practice referral interactions within the appropriate database according to the standards developed for the physician/provider practice and the CRO. Refers any clinical inquiries from patients to the appropriate Health Referral Nurse.
- Answers telephone inquiries regarding SJ/C and other community resources in a timely manner. Assists with general inquiries from the public regarding referrals, appointments, class/screening registration and web inquiries. All requests and actions are processed and documented in the CRO database accurately.
- Appropriately refers calls from patients and physicians to an RN if the request requires an explanation or interpretation of clinical data or information.
- Accepts responsibility to correct any pattern deficiency identified through quality audits, monitoring, or recordings. Demonstrates quality by documenting their actions in appropriate databases in a responsible, accountable and ethical manner. Strives to hit benchmarks as outlined in each key performance indicator. Maintains a positive and professional attitude.
- Refers patients to correct laboratory, imaging center, hospital or specialist. Ensures precertification is obtained when needed prior to services being rendered. Follows referral process based upon insurance company's policies and procedures.
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