Job Details

Dental Referrals Specialist

The Dental Referrals Specialist serves as the primary contact for all specialty referrals received from internal and external entities for dental services. Responsible for timely processing, documenting, scheduling, integration to other services and follow up of referrals and request for treatment authorizations as requested for PACE, Ryan White and other Specialty Services as needed.

Essential Functions of the Job:

• Submits, receives and processes authorizations in timely manner. Schedules all requests for referrals and treatment authorizations.
• Submits and follows up on medical releases required prior to patient appointment.
• Coordinates with the PACE or SY Health transportation as needed for patients or participants.
• Responds to inquiries as to status of authorization by assessing the request in EPIC Chart.
• Uses EPIC to access various work queues, obtain information regarding authorizations and schedules appointments, ensures treatment plans are sequenced correctly by RDA staff and submits for authorization as required.
• Communicates with all dental site PSR Leads to close the referrals loop. Reviews the referral list weekly to determine which patients have kept their specialty or consultation appointments and updates status with the respective clinic. Ensures that post-operative visit reports are received and scanned into respective patient document center.
• Update the referral excel worksheet with date and time of the appointment. Follow up after the documented date of visit and confirm if attended or failed and document accordingly in patient chart.

Additional Duties and Responsibilities

• Maintains established departmental policies and procedures, objectives quality assurance program, safety and environmental.
• Enhance professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.
• Attends meetings as required and participates in committees as directed.
• Performs other related duties as assigned or requested.

Job Requirements

Experience Required:

• 1 year of experience in a Dental office setting.
• Knowledge of dental terminology and referral authorization processes.
• Preferred: 1 year of experience as a Referrals Specialist, Patient Service Representative or similar role.

Education Required:

• High school diploma, GED or equivalent.

Verbal and Written Skills Required to Perform the Job:

• Bilingual required (Spanish/English).
• Good verbal and written communication skills in both languages.

Technical Knowledge and Skills Required to Perform the Job:

• Dental terminology and basic computer skills.
• Typing of 35 wpm.
• Ability to handle multiple activities simultaneously.
• Be attentive to patient needs and concerns.
• Willing to work with others as a team member.
• Able to work within a strict timeline.

Equipment Used:

• SYHealth computer, EPIC, Email and E-fax and other general office equipment.

Working Conditions and Physical Requirements:

• Prolonged periods of sitting, frequent walking and standing; minimal lifting.
• May be required to work evenings and/or weekends and attend meetings outside of regular working hours.
• Travel may be required.

Universal Requirements:

Pre-employment requirements include I-9, physical, positive background and reference check results, complete application, new hire orientation, pre-employment PPDs. Compliance with all mandated vaccinations and all boosters is a term and condition of employment.