Care Referral Specialist | FSU PrimaryHealth

Job Title: Care Referral Specialist | FSU PrimaryHealthLocation: Tallahassee, FLRegular/Temporary: RegularFull/Part Time: Full-TimeJob ID: 62610DepartmentFSU PrimaryHealth™FSU College of Medicine | Florida Medical Practice Plan2911 Roberts Ave.Tallahassee, FL 32310ResponsibilitiesResponsible for ensuring that the referral management process is complete and accurate at the FSU PrimaryHealth™ clinic. Refers patients to specialist according to insurance guidelines, obtains authorizations for new and follow up visits and ancillary appointments. Handles call-in requests for authorizations.Posts all referrals made on a daily basis into clinic referral log. Documents any referral denials in electronic medical record system. Communicates all rejected referrals with providers and follows through with any adjustments made. Answers inquiries about referrals following policy turnaround guidelines. Advises providers when diagnosis will not cover requested ancillary service. Educates providers and other office staff on changes to ancillary scheduling changes, authorization guidelines, and specific referral problems.Contact patients with appointment times and instructions, or if referral cannot be scheduled. Gives patient information on medication or prep needed for tests of ordered referral.Attends appropriate managed care payors sessions to ensure appropriate referral processing. Access, use and disclosure of Protected Health Information (PHI) are limited to a Professional Need to Know in accordance with FSU College of Medicine HIPAA policies and procedures. Contributes to the efficient operation of the clinic by performing other related duties as may be required. Promotes an atmosphere of teamwork in accomplishing the mission and goals of FSU PrimaryHealth™. Exhibit a willingness to float to all areas of need for administrative support including check-in, check-out, referrals, or other administrative areas as deemed necessary. Maintain confidentiality of all personal health information. Assure that information is maintained, handled, and released in accordance with applicable federal and state statutes and FSU PrimaryHealth™ policies.QualificationsHigh school diploma or equivalent and four years of experience. (Note: post high-school education and/or experience may substitute at a comparable rate.)Post-job offer, but prior to hire, the following will be required:Documentation of current PPD (Purified Protein Derivative) test as performed by a qualified physician, reporting negative results within the past six (6) months.Documentation of physical examination completed by a qualified healthcare provider/physician within the past six (6) months.Within 30 Days Of Hire, The Candidate Must ProvideDocumentation of Tetanus immunization within 10 years.Documentation of Hepatitis B vaccine or positive antibody titer.University InformationOne of the nation's elite research universities, Florida State University preserves, expands, and disseminates knowledge in the sciences, technology, arts, humanities, and professions, while embracing a philosophy of learning strongly rooted in the traditions of the liberal arts and critical thinking. Founded in 1851, Florida State University is the oldest continuous site of higher education in Florida. FSU is a community steeped in tradition that fosters research and encourages creativity. At FSU, there’s the excitement of being part of a vibrant academic and professional community, surrounded by people whose ideas are shaping tomorrow’s news!Learn more about our university and campuses.FSU Total RewardsFSU offers a robust Total Rewards package. Visit our website to learn more about our Compensation, Benefits, Wellness, Recognition, and Employee Development programs.Use our interactive tool to calculate Total Compensation options based on potential salary, benefits and retirement contributions, earned leave, and other employment-related perks.How To ApplyIf qualified and interested in a specific job opening as advertised, apply to Florida State University at https://jobs.fsu.edu. If you are a current FSU employee, apply via myFSU > Self Service.Applicants are required to complete the online application with all applicable information. Applications must include all work history up to ten years, and education details even if attaching a resume.Veterans' PreferenceCertain service members and veterans, and the spouses and family members of such service members and veterans, receive preference and priority, and certain service members may be eligible to receive waivers for post secondary educational requirements, in employment by the state and its political subdivisions and are encouraged to apply for the positions being filled. Veterans' Preference applies to University Support Personnel System (USPS) positions only.IMPORTANT: To claim Veterans' Preference, select “yes” to the question on the application questionnaire and upload a DD-214 (or equivalent), the Veterans' Preference Certification form, and other documentation if applicable with your online application before midnight of the position closing date.Click the links for eligibility information and required documentation, or call FSU Human Resources at (850) 644-6034.ConsiderationsThis is an USPS (University Support Personnel System) position.This position requires successful completion of a criminal history background check.Equal Employment OpportunityFSU is an Equal Employment Opportunity Employer.