Home Health Electronic Referral Specialist

Overview:

Electronic Referral Specialist - Full Time

Pittsburgh, PA

Advantage Home Health and Hospice is seeking a dedicated Electronic Referral Specialist to manage and monitor patient referral portals, ensuring timely and accurate processing for admissions across all Home Health and Hospice locations. This role serves as a vital liaison between patients, referral sources, and care centers to facilitate seamless care transitions while maintaining compliance with healthcare regulations and confidentiality standards.

Responsibilities:

Key Responsibilities:

• Process Referrals: Receive, accept/deny, process, and track patient referrals efficiently.
• Communication: Collaborate with physicians, nurses, and referral sources to obtain necessary patient information.
• Paperwork Management: Ensure all referral documentation is accurately completed and forwarded to the appropriate care center.
• Insurance Verification: Confirm patient insurance coverage for referred services.
• Start of Care (SOC) Scheduling: Coordinate patient SOC based on care center availability.
• Sales Team Support: Inform sales teams of new referrals to facilitate patient transitions and address inquiries regarding Home Health or Hospice services.
• Trending and Reporting: Maintain updated records of patient referrals, including outcomes on acceptances, denials, and lost opportunities due to service area limitations.
• Follow-Up: Engage with patients and referral sources to ensure timely delivery of care.
• Issue Resolution: Identify and resolve any issues or delays in the referral process.
• Confidentiality: Uphold patient confidentiality in adherence to HIPAA regulations.
• Data Entry & Documentation: Accurately input and maintain referral records within the Electronic Medical Record system, ensuring proper documentation for audits and reporting.
• Sales Strategy Execution: Implement strategies to meet and exceed sales goals for both Home Health and Hospice services.
• Relationship Building: Establish and maintain relationships with key stakeholders, including hospitals and referral sources.
• Market Analysis: Assist the VP of Sales and Business Development in analyzing market data and trends to identify new growth opportunities.
• Compliance: Ensure adherence to healthcare regulations and standards.
• Collaboration: Work with other departments to align sales efforts with overall company objectives.
• Orientation Support: Assist in the orientation of new Account Executives joining Advantage.

Qualifications:

Qualifications:

• Bachelor’s Degree or clinical experience preferred.
• 1-3 years of experience in medical office administration, referral coordination, or a similar role.
• Strong communication, organizational, and problem-solving skills.
• Ability to multitask and work in a fast-paced environment.
• Familiarity with medical terminology, insurance processes, and healthcare regulations (HIPAA, Medicare, Medicaid).
• Proven success in reaching/exceeding quotas.
• Strategic thinker with good business acumen.
• Ability to collaborate effectively with multiple teams and partners.
• Strong planning and organizational skills.
• Positive collaborator who balances taking initiative and direction as needed.

Other Duties:

Please note that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Advantage Home Health and Hospice is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Advantage is an equal opportunity employer, and all qualified applicants will be considered for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.