Referral Supervisor

Job Description

Job Description

COMMUNITY HEALTH :

Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties.

ABOUT THE ROLE :

The referral supervisor obtains reviews and inputs insurance authorization and referrals for patient services. The referral supervisor also ensures payment for services by verifying benefits with insurance providers.

FUNCTIONS OF THE POSITION :

• Supervises daily activities of referral staff, providing guidance, training, and performance feedback to ensure accurate and timely processing of authorizations and referrals.
• Coordinates work assignments, monitors workloads, and adjusts staffing as needed to maintain efficient workflow and service delivery.
• Participates in the hiring, onboarding, and ongoing training of referral team members.
• Conducts regular audits of referral and authorization processes, ensuring compliance with organizational standards and regulatory requirements.
• Serves as the first point of contact for referral team questions and escalated issues, facilitating problem-solving and ensuring prompt resolution.
• Develops and maintains standard operating procedures for the referral team, updating documentation as necessary to reflect best practices.
• Assists the Patient Access Manager in developing performance metrics, monitoring outcomes, and recommending process improvements.
• Reviews providers order to ensure referrals are in place prior to service.
• Receives, maintains and notes in the system all referrals for services.
• Run reports on a scheduled basis to obtain accuracy and to keep providers and staff informed of referrals / testing.
• Interviews and assists patients with authorization documents as needed.
• Maintains appropriate reports according to Community Health policy, state and federal requirements.
• Monitors and tracks patient authorizations, informing supervisor of any expired dates if applicable.
• Participates in required meetings.

OTHER DUTIES :

SKILLS REQUIRED FOR SUCCESS :

HOW WE SUPPORT YOU :