The referral specialist will review, analyze and document all referral requests, obtain appropriate authorizations for all plans (UHC Navigate, Global Health, Medicaid/Soonercare, Triwest, etc) and process from referrals once patient is seen by OSU provider. 

• Essential Functions and Responsibilities: Daily queue accessed and analyzed to prioritize work to achieve optimal care for patients 

• Includes research of referral to determine if all documentation is included necessary to process request and to assist in obtaining authorization if required  

• Departmental protocols to be followed to ensure consistency in documentation in Epic as well as any communication to ensure completion 

• Works with team to ensure daily coverage 

• Communication with staff, offices, and diagnostic locations to ensure referral received and /or appointment date and time is arranged and documenting in patient’s referral 

• Responsible to locate specialty physicians and maintain desktop reference information relating to assigned specialty to serve as knowledgeable resource 

• Answer telephone calls on OSU Referral line and OSU CareLine 

• Determine match for patient based on geographic area, insurance and presenting medical problem(s) to facilitate patient care 

• Also serve as contact point for OSU office staff with 'same day' referral questions and inquiries about patient referral status 

• All staff share Referral log that includes providers office outside EMR system and are responsible to be knowledgeable of resources 

• Ensure that questions, potential delays and changes are brought to the attention of supervisor and/or manager for support and update of information to facilitate processing of referrals 

•  Decision Making: The carrying out of non-routine procedures under changing conditions, in conformance with general instructions from supervisor 

• Working Relationships: Works directly with providers and staff  

• Works with internal customers via EMR and telephone 

• Works with other healthcare professionals and staff