Referral Specialist, Multispecialty

Site: Mass General Brigham Medical Group Western Massachusetts, Inc.

 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

 

The Mass General Brigham Medical Group is a system-led operating entity formed by Mass General Brigham to deliver high quality, low cost, innovative community-based ambulatory care. This work stems from Mass General Brigham’s unified system strategy to bring health care closer to patients while lowering total health care costs. The Medical Group provides a wide range of offerings, including primary care, specialty care, behavioral and mental health, and urgent care, both digitally as well as at physical locations in Massachusetts, New Hampshire, and Maine. The group also offers outpatient surgery and endoscopy, imaging, cardiac testing, and infusion. We share the commitment to delivering a coordinated and comprehensive experience across all locations, ensuring the appropriate level of care is available to every patient across our care delivery sites.

We are located at 22 Atwood Drive, Northampton, MA. This multi-specialty medical office building is a part of Cooley Dickinson’s Atwood Health Center, a spacious facility with a variety of Cooley Dickinson services and serves as a one-stop health and wellness destination. While working at 22 Atwood, you will be able to support a variety of offices/specialties, including but not limited to: Women’s Health, the Diabetes Center, Infectious Diseases, Family Medicine, Rheumatology, Endocrinology, Geriatrics, Podiatry, Spine Medicine, and Integrated Behavioral Health

 

Job Summary

We are seeking a full-time, 40-hour Referral Specialist to join our team! This is a schedule of Monday-Friday 8:30pm-5:00pm and we are located at 22 Atwood Dr., Northampton, MA 01060. As a hybrid opportunity, this position typically covers 2 days per week on-site and remote for 3 days. The schedule is flexible based on the department’s needs.

Employees are expected to be onsite for all hours worked during the first 90 days of employment for onboarding/training. There are options for hybrid work rotation after the successful completion of the training program, based on performance.

The Referral Specialist is responsible for ensuring third party payer referral requirements are met.

Responsibilities include:

Receive and process specialty referral orders from providers or patients using the electronic health record. Ensure timely coordination of specialty care for patients.
Verify insurance policy benefit information and obtain authorization/pre-certification, or re-verification prior to the patient's visit or scheduled admission.
Give patient and referral information to patients, third party payers, specialists, and other health care providers. Provide guidance to patients and other health care providers as to referral process requirements.
Assist providers in obtaining information as needed, including diagnosis codes, procedure codes, and pricing information.
Document all referral processing steps throughout multiple stages, as well as patient and coordination interactions, using the electronic health record system.
Follow up on pending referrals and work to obtain progress note from specialist.
Maintain established organizational and departmental policies and procedures, objectives, confidentiality, quality improvement program, compliance, safety, infection control, and environmental standards.
Maintain professional growth and development through attendance at seminars, workshops, conferences or in-services, professional affiliations, or journals to stay abreast of current trends in field of expertise.
Meet annual competency and retraining requirements.
Attend meetings as required.
Perform other functions/duties as requested.

Are you ready to bring your talent to this team and join us in moving health care forward?

 

Qualifications

Education High School Diploma or Equivalent required and Bachelor's Degree Related Field of Study preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Experience scheduling experience in administrative medical office setting 3-5 years required Knowledge, Skills and Abilities - Strong communication and organization skills. - Ability to manage multiple projects and tasks at once. - Attention to detail. - Ability to problem-solve. - Possess time management skills.

 

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