PruittHealth este o organizație de servicii medicale deținută de o familie, care oferă îngrijire pacienților și familiilor din sud-estul Statelor Unite. Fondată în 1969, compania furnizează servicii de nursing specializat, îngrijire medicală la domiciliu, îngrijire hospice și paliativă, precum și servicii de locuire pentru vârstnici. Activitatea sa cuprinde furnizarea de servicii medicale, îngrijirea vârstnicilor și servicii de sănătate conexe, punând accent pe informarea familiilor cu privire la deciziile de îngrijire și la evoluția celor dragi.
Community Referral Specialist – PruittHealth, Norcross Onsite
Evaluate patient referrals and coordinate admissions for PruittHealth home health services in Norcross. Manage insurance verification, referral documentation, and collaboration with providers and internal teams.
Descriere
- Handle incoming referrals from key referral sources
- Assess referrals for admission to PruittHealth
- Review patient referrals and respond within productivity expectations
- Complete referral documentation while maintaining a data-entry error rate of 1% or less
- Manage incoming calls and answer them before the third ring
- Route each referral to the appropriate next person in the process
- Verify insurance coverage and eligibility when assigned
- Coordinate with the clinical team until admission is scheduled
- Participate in morning huddle calls
- Work with the revenue cycle team on payor, verification, and authorization requirements
- Escalate referral issues and barriers to the manager
- Review physician orders and obtain clarifications or additional information
- Identify objections, concerns, and entry barriers, then provide information and alternatives
- Process and document referrals that are not accepted for admission
- Use multiple electronic health systems to receive referrals
- Monitor agency status across staffing, payor, and clinical capabilities
- Collaborate with sales partners, administrators, and clinical managers
- Support referral processing, evaluate payors, and conduct welcome calls as needed
- Perform other related duties assigned by the supervisor
Cerințe
- High school diploma or equivalent
- At least one year of healthcare environment experience, or an equivalent combination of training and experience
- Clerical, computer, and data-entry skills
- Basic medical terminology knowledge
- Understanding of private insurance and Medicare coverage criteria, rules, and regulations
- Knowledge of regulatory agencies, reimbursement systems, and levels of care
- Ability to learn and use multiple electronic health systems and platforms
- Compliance with the Code of Conduct, applicable state and federal regulations, accreditation standards, and organizational policies and procedures
- Ability to protect the confidentiality of patient and employee records and information
Beneficii
- Equal Employment Opportunity employer
- Continuing education programs covering field changes and supporting current licenses or certifications when required