PruittHealth
PruittHealth
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 (Onsite)

Coordinate patient referrals and admissions for PruittHealth’s Home Health network. Work with insurers, clinical teams, referral sources, and provider partners to support timely admissions.

Descriere

  • Coordinate incoming referrals from designated sources
  • Assess referrals for admission using clinical experience and knowledge of Home Health services
  • Help Community Relations Representatives maintain referral-source partnerships
  • Review patient referrals and respond within established productivity targets
  • Complete referral records accurately while maintaining a data-entry error rate of 1% or less
  • Handle incoming calls and answer before the third ring
  • Route each referral to the appropriate next person in the management process
  • Verify insurance coverage and eligibility when assigned
  • Coordinate with the clinical team through scheduled admission
  • Participate in morning huddle calls
  • Work with the revenue cycle team on payor and verification or authorization requirements
  • Escalate barriers and issues to the manager
  • Review physician orders and contact referral sources for clarification or missing information
  • Recognize objections and access barriers, provide relevant information, and suggest alternatives when services are unavailable
  • Process and document referrals declined for admission, including the specific reasons
  • Use multiple electronic health systems to receive referrals
  • Track agency status across staffing, payor, and clinical capabilities
  • Manage contacts for assigned agencies
  • Collaborate with sales partners, administrators, and clinical managers
  • Assist with additional referral processing, payor review, and 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 education and training providing the necessary knowledge and skills
  • Required clerical, computer, and data-entry skills
  • Working knowledge of basic medical terminology
  • Fluency with regulatory agencies, reimbursement systems, and levels of care
  • Knowledge of private insurance and Medicare coverage criteria, rules, and regulations
  • Ability to learn and use multiple electronic health systems and referral platforms
  • Willingness to participate in continuing education and maintain any required license or certification
  • Commitment to patient and resident rights, confidentiality, ethical conduct, regulatory and accreditation standards, and company policies
  • Strong communication and customer service skills when working with patients, families, visitors, referral sources, and provider networks

Beneficii

  • PruittHealth provides equal employment opportunity regardless of race, color, religion, sex, national origin, disability, or veteran status.

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