Neighborhood Outreach Access to Health (NOAH) is looking for talented healthcare team members to step into our culturally diverse health centers! From Scottsdale to Glendale, NOAH provides affordable, high-quality healthcare services. Serving over 40,000 neighbors, our model of care places patients needs at the center of attention as we deliver comprehensive health services including medical, dental, behavioral health, nutrition, prenatal care, preventive health, eligibility assistance and health education programs.

JOB SUMMARY
The Referral Specialist at NOAH is responsible for serving as a specialist in the coordination of all aspects of specialty referrals incoming and outgoing, eligibility verification, and maintenance for practice patients. This responsibility includes obtaining client information, maintaining patient files, verifying information with appropriate agencies, and reporting statistics and data as required. Obtaining referral and prior authorizations, assist providers, staff, and patients with referral questions. Process referrals and sending eligibility information for NOAH's sliding fee scale patients. Verification of coverage and correct documentation within the patient medical record to complete the referral process thoroughly within the EHR system. Referral Specialist will complete internal behavioral health and nutrition referrals according to their benefits. Referral Specialist will ensure process is completed accurately through each work queue to adhere to all governing federal regulations, including FTCA deeming requirements associated with the NOAH program.

JOB RESPONSIBILITIES
These are essential job responsibilities and should be listed in descending order of importance i.e. most important is first.

ESSENTIAL FUNCTIONS

• Serves as a specialist in processing and approving selected specialists referrals according to policy and procedure established by the Network in general and PN specifically.
• Obtains referral request documentation
• Maintain ongoing tracking and appropriate documentation on referrals within the three work queues that are assigned and closing the loop.
• This tracking is done through an EMR system along with an ICP system.
• Demonstrates a high degree of accuracy and timeliness in completing referral authorizations/prior authorizations
• Compiles all pertinent medical data and supporting documentation and faxes or mails to appropriate receiver.
• Verifies eligibility, benefits and contractual appropriateness.
• Acts as liaison between practice, patients, referral sources, and health insurance companies to resolve complaints and problems.
• Serves as expert internal consultant to all levels of practice staff.
• Monitors and resolves the status of problem authorizations
• Assemble information concerning patient's clinical background and referral needs. Per referral guidelines through their specific insurance plan, provide appropriate clinical information to specialist.
• Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis.
• Ensure that referrals are addressed within a timely manner.
• Responsible for recording information within referral in order to assist in the tracking of referral and to assist and to assure follow-up.
• Ensure that patient's primary care chart is up to date with information on specialist consults related to their health.
• Review details and expectations about the referral with patients.
• Responsible for training and orientation of new Referral Coordinators into practice.
• Trains new Referral Coordinator employees on correct policies and procedures as needed.
• Continually maintains Health Insurance Portability and Accountability Act (HIPAA) and other compliance requirements.
• Enters non-clinical information into patient electronic medical record (EMR system. Ensures all required information is keyed in thoroughly and accurately.)
• Views non-clinical information in EMR system.
• Independently formulates information to be entered into EMR.
• Obtains information to be entered from multiple sources such as providers, nurses, etc.
• Logs, tracks, and resolves issues within specific timeframe to ensure accuracy and timeliness of data entry.
• Brings errors and/or issues to the attention of designee.
• Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
• Navigates through multiple complex EMR screens and enters data.
• Remind patients of scheduled appointments via EMR system, by mail, or by phone.
• Performs other duties as assigned.

Benefits are available for both full-time and part-time employees!
The above job responsibilities describe the general nature and level of work to be performed. It does not restrict managements right to assign or re-assign duties at any time.

Benefits include:

Medical Coverage
Prescription Drug Coverage
Dental Coverage
Vision Plans
Tuition Reimbursement Program
Paid Time Off (PTO)
Paid Holidays
Retirement 403(b) plus company match
Pet Insurance

JOB QUALIFICATIONS

EDUCATION
Required

• High School Diploma or GED

Preferred

• Associate's Degree

EXPERIENCE
Required

• 1 year - of full-time health care clinic work experience

Preferred

• 2 years - of full-time health care clinic work experience

CERTIFICATIONS/LICENSURE/ETC.