Referral Specialist - Family Health Clinic 8am-5pm

Moore County Hospital District (MCHD) is an award winning Critical Access Hospital located in the High Plains of Texas in the town of Dumas. The National Association of Rural Hospitals named MCHD to the Top 20 Rural Hospitals in the US for Quality (#9)! MCHD serves MCHD is a recipient of the Hurst Gold Standard of Nursing Award, the Studer Excellence in Patient Care Award, the TORCH Light award, the Joint Commission Top Performer award, the Texas Healthcare Quality Improvement Award, the Studer Healthcare Partner of the Month award, the Home Care Elite award, and more. MCHD's 2019 Press Ganey Employee Engagement Survey ranked MCHD in the top 95% of healthcare organizations nationally for employee job satisfaction and engagement, in the top 96% for 2020 and 2021! MCHD has averaged in the 94th percentile in the US over the past 8 years! This is a Full Time Position. Summary: The Referral Specialist coordinates, processes and documents medical referrals and prior authorizations for a variety of medical services for clinic patients. This requires clinical knowledge and understanding of CPT and ICD-10 codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations. The Referral Specialist manages a high volume of referrals and pre-authorizations for multiple Providers and collaborates with other Clinic Referral Specialists, Providers, Medial Assistant(s), Front Desk Coordinator(s) (Medical Receptionist) and other support staff in multiple clinic locations. This position requires the use of clinical and administrative judgment and initiative to determine best approach for both urgent and non-urgent patient care needs. Job Functions: Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with patients' insurance requirements. Per referral guidelines, provide appropriate clinical information to specialist. Perform eligibility determination for clinic patients. Performs other duties as assigned. Prepares and processes all referral and pre-authorization paperwork, including gatherings pertinent information as needed via EHR, from incoming phone/email/fax messages, or from clinical team. Contacts various clinics, facilities, and companies to obtain information to accurately complete referral/pre-authorization requests. Skills: Ability to maintain good interpersonal interactions with clients and co-workers as a member of the team with a diverse multi-cultural population. Ability to multi-task, be flexible, ensure accuracy, and meet changing priorities in a fast-paced, high-workload environment. Basic computer literacy (i.e., use system to manage and schedule appointments, access electronic medical record information). Basic organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals. Clinical knowledge of medical terminology, medical procedures, CPT, and ICD-9 (10). Intermediate knowledge of insurance providers, their portals and their expectations for authorization approval. Education: High school diploma or GED equivalent preferred. Requirements: Must be bilingual in English and Spanish.