Muscp – Referral Representative

Job Description Summary

Obtains and processes signed physician orders/referrals to ensure accurate clinical documentation for care delivery, specialty and outpatient ancillary referrals. In addition, the referral coordinator will conduct online insurance eligibility/benefit verification, obtain pre-certification/authorization, referral clearance and financial education on designated cases. As appropriate; notifies patient/guarantor, specialist, referring provider, etc., with pertinent information, inclusive of, but not limited to clinical documentation, referral status, follow-up, etc.

Entity

Carolina Family Care, Inc. (CFC)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC000102 CFC PC Primary Care Referral Specialist CC

Pay Rate Type

Hourly

Pay Grade

Health-21

Scheduled Weekly Hours

40

Work Shift

Job Description

• Processes referrals for the MUSCP Primary Care offices
• Upon receipt of referral from the MUSC Physicians Primary Care offices, schedules appointments for specialists and diagnostic testing utilizing Epic to schedule or by contacting the departments.
• Obtain pre-authorization number from patient’s insurance company as required for appointments.
• Provides support to the office staff and providers via Epic inbasket message, phone calls or emails in reference to questions or concerns involving referrals.
• Data entry of referral for tracking purpose. 
• Process community referrals by sending the patient’s referral and medical records to the community providers and verifying patient’s appointment.
• Closing the loop with PCMH, patients must be contacted after any no showed and canceled appointment to reschedule their appointment.
• Follow up on pending referrals in a timely manner.
• Communicate appointment information to include appointment date, time and location with the patient. Print and mail correspondence related to scheduling when needed.
• Perform Referral Specialist duties as assigned by Referral Manager and maintain departmental protocol.
• Serve as a liaison to all MUSC Entities and the general public
• Act as liaison to ensure appointment access with appropriate departments and the community offices. This role triages patient calls/messages, and provider/office staff calls and inbasket messages according to established protocol to answers questions, resolves issues and refer to appropriate departmental contact as needed to ensure a positive overall patient experience.
• Perform routine and advanced clerical duties
• Answer multi-line telephone, handle calls appropriately, filing and make copies.
• Responsible for maintaining adequate inventory of office supplies with the approval of the Referral Manager.
• All other related duties as assigned by Referral Manager
• Provide assistance with referrals to the MUSC Physicians Primary Care office staff and physicians when needed.

Additional Job Description

Required Minimum Training and Education: High School Degree or Equivalent Work Experience: 0-6 months

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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