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Heywood Hospital Referral Specialist, HMG, Tully Family Medical, 40 Hours, Day Shift in Gardner, Massachusetts

Job Summary Under the direction of the Senior Practice Manager incumbent is responsible for answering phones, arriving patients, appointment scheduling, insurance verification, referral processing, scheduling of outpatient services, and managing daily deposits. Accurately documents information provided by patients and processes incoming faxes and daily mail. Incumbent participates in customer service and patient satisfaction initiatives. Incumbent maintains ongoing tracking and appropriate documentation of referrals and authorizations. Ensures that referrals are scheduled in a timely manner . Must learn and perform new standards and processes as they are implemented and complete any assigned training. Responsible for other duties and locations as assigned. See full description below. Job Requirements Minimum Education * High School diploma or equivalent required Minimum Work Experience * One (1) year of experience in a medical office preferred Required Skills * Excellent written and verbal communication skills * Excellent customer service skills * General comfort level with computers/technology and ability to learn programs as needed. Knowledge of Electronic Medical Records Preferred and word processing skills * Preferred knowledge of medical terminology * Must be able to work flexible shifts, some evenings & weekends may be required. Reliable transportation in order to travel between locations is also required. Physical Requirements*:* Exerts up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands). Essential Functions * Conducts interactions with everyone in a friendly, courteous and respectful manner. * Goes out of his/her way to offer assistance to others. If he/she cannot offer assistance, then finds someone who can. * Advocates to ensure privacy and confidentiality while helping others to maintain awareness. * Maintains a clean and safe practice and hospital. * Responds appropriately and immediately in emergency situations. * Maintains a safe and healthy environment for patients, visitors, and/or staff to provide the highest level of physical comfort, and minimize risk and injury. * Ensures compliance with regulations to maintain accreditation and licensure. * Complies with the Heywood Healthcare Attendance and Tardiness Policy. * Completed all Heywood Healthcare and Department Specific Mandatory requirements in the prior calendar year. * Reports Incidents in a timely and effective manner. * All employees with direct patient contact are responsible for actively engaging in the practice of, monitoring and enforcing compliance to hand hygiene. * Schedules and coordinates patient referrals to ordered services expeditiously. * Establishes a close working relationship with preferred providers to facilitate scheduling. * Ensures any necessary paperwork, medical records and insurance referrals are processed and provided to specialty provider in advance of patient appointment. * Thoughtfully communicates with patients regarding scheduled services, accurately providing any necessary information such as, date, time, prep, pre-registration requirements, etc. in advance of the appointment. * Issues patients managed care referrals as required. * Obtains necessary prior- authorizations for ordered procedures and diagnostic studies as required. * Stays current with insurance referral and prior-authorization requirements. * Has working knowledge of our local network/preferred providers and works with practice providers and PHO to minimize leakage. * Actively participates in quality measure management. * Verifies insurance coverage and eligibility. * Completes PT-1 forms as required for patient transportation to scheduled services. * Completes tasks associated with clinical inbox/ practice buckets (personal, practice referral, medical record and others assigned) proficiently and in a timely manner * Assists in appeals process as directed. * Closes the referral loop-follows up on assigned open orders-results/consults pending * Acts as office communications liaison for patients and healthcare providers for referrals and authorizations. * Maintains records, reports, logs and other statistical information as required or directed. * Complies with established departmental policies, procedures, and objectives * Attends variety of meetings, conferences, training and seminars as required or directed. * Demonstrates use of quality improvement in daily operations * Respects diverse views and approaches, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. * Provide coverage when needed at other locations within Heywood Medical Group. * All other duties and locations as assigned Statement of Other Duties This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described. Facility: Heywood Medical Group Department: HMG TULLY FAMILY,2002.70140 Regular or Temporary Position: Regular Position Control #: 2002.70140.8191 Position Hours: 40 Shift: Day/Evening Job Title: Referral Specialist, HMG, Tully Family Medical, 40 Hours, Day Shift Location: Gardner, Massachusetts Posted Date: 04/21/2021

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