Lead Referral Specialist

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Serves as the initial point of contact for scheduling, messaging and operational questions from the Scheduling Call Center staff. Acts as a liaison between the scheduling staff and the manager, clinics, patient access, and call center to ensure appropriate communication of issues and protocol changes. Develops, trains and monitors departmental training. Orients and mentors new employees. Also continues to perform the duties and functions of a referral specialist.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High School or Equivalent.

EXPERIENCE:

1. Three years clinical or customer service experience.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. Five years of experience with direct customer service.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Develops and initiates training protocols, resources and new employee orientation.

2. Orients and mentors new employees.

3. Addresses and resolves patient/customer and physician complaints.

4. Manages communication and coordination between the patient/customer and the providers/clinic.

5. Attempts to optimize and increase efficiency of visit or procedure by recommending potential alternatives.

6. Manages calls in such a way that urgent situations related to the provision of patient care are handled in an appropriate manner.

7. Receives and responds to patient and staff needs and complaints appropriately within the realm of the patient care environment, involving department supervisors and patient representative as needed.

8. Addresses insurance issues.

9. Educates patients regarding insurance denial or out of networks status.

10. Enrolls providers in new insurances as applicable.

11. Develops workflow changes to address identified issues.

12. Maintains training records and notifies manager of training issues.

13. Initial Point of contact for referral specialist in the spine center.

14. Leads departmental and divisional meetings and records minutes in the absence of the manager.

15. Epic process clarification.

16. Maintains monthly schedule and daily assignments, adjusting them to flex with staffing and scheduling priority.

17. Identifies urgent patient requests/needs and escalates to the RN.

18. Develops and maintains workflow with outside facilities for electronic image sharing within Image Grid.

19. Works closely with manager, patient access, call center, and clinics to communicate and address any process changes, protocol, and guideline changes and employee issues.

20. Participates in peer interviewing.

21. Participates in meetings with clinic management, responsible for attending meetings; coordinating schedules, breaks and lunches.

22. Communicates guideline changes to the spine center staff and addresses any questions that may arise as a result of the change.

23. Monitors productivity and adjusts daily assignments to ensure timely patient care.

24. Performs all duties of a referral specialist within the spine center.

PHYSICAL REQUIREMENTS: The physical demands described here are representative 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.

1. Frequent walking, sitting, stooping, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.

2. Must be able to sit for extended periods of time.

3. Must have reading and comprehension ability.

4. Visual acuity must be within normal range.

5. Must be able to communicate effectively.

6. Must be able to exert in excess of 50 pounds of force occasionally to move objects.

7. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

WORKING ENVIRONMENT: 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.

1. Office type environment

SKILLS AND ABILITIES:

1. Communicates effectively verbally and in writing and places high emphasis on customer service with referring physicians/offices and patients. 

2. Demonstrates flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs (i.e. weather or disaster).

3. Working knowledge of computers.

4. Basic knowledge of medical terminology preferred.

5. Basic knowledge of third party payers preferred.

6. Must demonstrate the ability to use tact and diplomacy in dealing with others.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Day (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

THOM Thomas Hospitals

Cost Center:

550 THSP Scheduling Call Center

Address:

333 Laidley StreetCharlestonWest Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.