Referral Specialist

Full Time
Enid, OK 73701
Posted
Job description
Responsibilities


St. Mary’s Physician Associates is a multi-specialty group of employed physicians and midlevel providers that serve a ten-county area in NW Oklahoma. It is located in Enid, Oklahoma which is the county seat for Garfield County. Enid is the seventh largest city in Oklahoma with a population of approximately 65,000 but their primary service area in NW Oklahoma consists of 200,000. The group has satellite clinics in Hennessey, Fairview, Okeene, Woodward, and Ponca City. St. Mary’s Physician Associates is affiliated with St. Mary’s Regional Medical Center, a 229-bed facility.


Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.


Referral Specialist

Responsible for scheduling referrals for patients of St Mary’s Physician Associates providers, Pre-authorizing & pre-certing tests/procedures for St. Mary’s Physician Associates providers. Scheduling of other tests with facilities at the request of SMPA providers and/or staff. Directly communicates with the SMPA clinics, referred to clinics, and patients. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision and values of St. Mary’s Physician Associates, LLC.

  • Communicates effectively with SMPA clinics and hospital.
  • Communicates effectively with patients.
  • Communicates information to appropriate areas, departments and individuals.
  • Addresses patients in a polite, prompt and helpful manner
  • Orders supplies for the office within budgetary guidelines.
  • Returns all emails within 48 hours
  • Schedules tests and referral appointments within 24 hours from receiving the physician order.
  • Notifies patients within 24 hours of their appointment.
  • Maintains a daily referral log.
  • Pre-certify appropriate tests with insurance companies within 48 hours of physician order.

As a St. Mary's Phyisican Associates employee you will be part of a first class organization offering:

  • A Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match

Qualifications


Required:
  • High school graduate or GED required.
  • Minimum of two years’ experience in a healthcare or clinical setting.
  • Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance regulations and HIPAA privacy standards is strongly preferred.
  • Typing, 10 key and computer skills required.
  • Proficiency in Microsoft Office applications required.
  • Required effective interpersonal skills and excellent written, oral communication skills required.
  • Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred. Knowledge of third party reimbursement regulations is preferred.
  • Patient Management, Billing and Managed Care system processes competency. Understanding of functions and work flow of Clinical/Hospital departments.
  • Excellent planning and organizational skills. Demonstration of strong analytical skills and problem-solving abilities. Strong teamwork skills and the ability to effectively communicate with all management levels.
  • Results oriented, independently goal directed, able to multi-task and meet established time frames.
  • Excellent customer service skills and must be able to work independently.

EEO Statement

It is the policy of the Facility to provide equal opportunity in employment to all employees and applicants for employment. No person will be discriminated against in employment on the basis any legally protected characteristics such as race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age (40 and over or as otherwise defined by applicable law), disability or genetic information (including family medical history) or protected veteran status, or any other characteristic protected by applicable Federal, State, or local law. For purposes of this policy, race includes traits historically associated with race, including but not limited to, hair type, texture, length and protective hairstyles (including but not limited to, braids, locks, twists, Bantu knots, hair coverings, etc.). If certain workspaces require such restrictions for health and safety reasons, non-discriminatory accommodations should be considered and implemented if feasible.

Notice

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

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