Referral Specialist - Philadelphia, United States - Philadelphia Fight

Philadelphia Fight

Verified Company

Philadelphia, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Philadelphia FIGHT

Jonathan Lax Treatment Center

Referral Specialist Job Description
The Pharmacy Technician is responsible for supporting pharmacy-related activities within FIGHT Community Health Centers alongside the Clinical Pharmacist.

The Pharmacy Technician's key role is to ensure patients have access to their medications by forwarding refill requests to providers, obtaining prior authorizations through insurance plans, communicating with dispensing pharmacies to problem-solve, enrolling patients in copay assistance, coordinating delivery of office-administered medications, and working together with health center staff to address other issues that may arise.

Qualifications:
The Referral Specialist must have a minimum of 3 years of experience in healthcare insurance. Must be able to demonstrate judgment, patience, integrity, organization, and prioritization in a multi-task environment. Needs to have attention to detail, dependability, listening and communication skills, and flexibility. Must have cultural competency. Bilingual (English/Spanish) preferred.

Responsibilities include:

Referrals:

Schedule specialty appointments for all patients.
Schedule imaging studies and procedures.
Process prior authorizations for all imaging and radiology appointments.
Process required referrals through insurance portals (Avility).
Fax all required referral forms to specialty provider.
Labs
Authorizations
Scripts
Provide directions to specialty appointments, as needed.
Send reminder letters with referrals and scripts for appointments.
Perform reminder calls for all specialty, imaging, and procedure appointments.
Perform monitoring call to place of service.
If appointment was not kept, reinitiate scheduling process.
Enter specialty appointment data into the referral request in EMR.
Scan and upload all consult report(s) and attach to referral(s) in EMR.
Request outstanding consult report(s) from specialty and imaging provider(s).
Track and close referral request once consult report(s) have been uploaded in EMR.
Maintain updated referral lists, including specialist requirements for referrals.
Handle all requests for referrals which includes Fibroscan referrals and appointment scheduling. Perform other duties as requested.

Function in a Team:

Work in compliance with all medical policies.
Demonstrate commitment to clinical care and confidentiality.
Work in compliance with standards such as OSHA, HIPAA, CLIA and funding body regulations.
Exercise good judgment in bringing any issues necessary to the attention of the Practice Manager.
Constantly strives to achieve excellence in the daytoday operations of the Jonathan Lax Treatment Center.

Other:
Initial probationary period is three months. Performance of other tasks may be assigned on an as-needed basis.

Salary range:
Competitive; Hourly

Travel Requirements:
Minimal local travel required between Philadelphia FIGHT Health Centers.

Work Hours: 40 Hours/Week (M-F 9:00am - 5:00pm)

Philadelphia FIGHT requires proof of completed COVID-19 vaccination series for all new employees hired. Medical and religious exemptions will be honored consistent with EEOC regulation.

FIGHT is an EEO, Affirmative Action, LGBTQ, people living with HIV/AIDS, and protected veterans' institution.

**We recognize that an inclusive workforce with a variety of views, perspectives, and backgrounds is an integral part in our organizational success. We encourage and embrace a diverse workforce that provides us with unlimited ideas and innovative solutions. We are dedicated to recruiting, hiring, and retaining employees from many backgrounds.