Job Description

Job Title:                       Referrals Clerk

Reports To:                        Medical Records and Referrals Supervisor

Job Summary:                     Processes and follows up referrals and some diagnostics, supplies clerical support to providers and support staff.

                                                                                                                                                                       

Qualifications and Requirements:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  This job description in no way implies that these are the only duties to be performed and may be modified, interpreted, and/or applied in any way, as necessary.  Maintaining regular and punctual attendance is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Essential Job Duties:

  • Obtains Referral notes from specialists as required.
  • Acquires and documents referral information from physicians, patients, and insurance carriers.
  • Reviews referral paperwork to ensure that referrals are appropriate for the insurance carriers.
  • Ensures that prior authorizations are completed for referrals as required by the insurance carriers.
  • Follows-up to ensure that all required documents have been received by insurance carrier and referral is processed.
  • Processes diagnostics orders according to policies and procedures. 
  • Runs reports according to policies and procedures to follow up on open referrals and diagnostics until closing the loop, electronically filing and documenting steps in the process.
  • Working assigned weekends is required.

Required Education, Experience, Certificates & Licenses:

  • High School Diploma or GED.
  • Experience in medical records or referrals preferred.
  • Any combination of experience and/or education that provides the skills and sensitivity.
  • Valid Fingerprint Clearance Card.

Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.

Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.

Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide, using whole numbers, common fractions, and decimals.
  • Ability to gather data in an organized fashion from varied sources.
  • Ability to take direction and perform assignments accordingly.
  • Knowledge of all aspects of insurance referral process.
  • Computer literacy required.
  • Knowledge of Electronic Health Records preferred.
  • Understands covered services and contracted physicians enrolled with various insurance carriers.
  • Ability to provide excellent customer service by mail, telephone, and in-person.

Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.