OrthoVirginia, Virginia's largest provider of expert orthopedic and therapy care, is currently seeking a full-time, Lead Referrals Specialist to join our team! This position is remote. Candidate MUST reside in Virginia. Along with a collaborative, team-oriented work environment, our outstanding employment package includes competitive salaries, excellent medical, dental, and vision benefits, paid time off (PTO), a generous 401k incentive plan, short-term and long-term disability insurance, life insurance, and a company-wide wellness program.

Job Summary

In conjunction with Operations, the Lead Referrals Specialist is responsible for the day-to-day operations of the Referrals department. This position will ensure all daily authorizations are obtained by coordinating and monitoring work queues, with particular interest in STAT and incomplete referrals. This position can be a remote position.

Primary Functions and Accountabilities

. Monitor productivity, assign tasks as appropriate, perform Referral Specialist duties when needed, and act as a resource for team members, managers and/or providers.

. Display and promote a positive public relations approach to team members, patients, providers and the public.

. Communicate with physicians, team members and patients when needed to achieve a positive and successful patient impression.

. Oversees completion of Referral work queue tasks. Reviews them throughout the day to identify STATS and problematic authorizations before procedure/surgery date to avoid denials.

. Work to maintain team member compliance of all referral procedures.

. Handles difficult patient situations and encounters.

. Serves as a path of escalation when necessary to providers, management, clinical staff and end users.

. Acts as a liaison between OrthoVirginia and third-party vendors, providers, payers and facilities.

. Respond immediately to urgent needs within the Referrals department.

. Assist with interviewing candidate selection for referrals roles in conjunction with the Operations Manager.

. Assist with coordinating new hire orientation and training processes.

. Assist in maintaining appropriate levels of staffing for Referrals.

. Coordinate staffing with the Operations Manager in the event a team member will be absent or late for work.

. Assists in individual productivity reporting and other weekly or monthly reporting as needed. Helps determine individual success based on team metrics.

. Evaluates quality of work by using specific criterion designated to identify opportunities for continued education and Epic optimization.

. Offer input for annual performance evaluations in conjunction with Operations Manager.

. Organize and assist with leading department meetings in conjunction with the Operations Manager.

. Serves as a subject matter expert for the Referrals department.

. Maintain flexible work schedule to meet patient care and administrative needs.

. Performs other related duties as assigned.

Knowledge, Skills and Abilities

. Knowledge of standards applicable to referrals including billing and insurance/managed care policies and procedures, HIPAA, etc.

. Knowledge of general medical terminology

. Ability to communicate effectively, both verbally and in writing, with patients, team members, direct reports, providers and management group

. Ability to work well with high volume and/or under pressure

. Ability to maintain composure during stressful situations

. Ability to grasp new tasks in a timely manner

. Ability to maintain strict confidentiality

. Proficient computer and typing skills

. Proficient problem identification and resolution skills

. Proficient interpersonal and negotiation skills

. Strong organizational skills with ability to multi-task and work at a fast pace

. Excellent customer service skills to effectively work with patients and the public

Position Requirements

. High school diploma or GED equivalent required

. Associate degree preferred

. 1-3 years of experience in authorizations, referrals or a related field required

. Experience in a medical office setting preferred

. Some leadership experience preferred