Referral Specialist
12 days ago
Los Angeles
Job Description INTRODUCTION Company Overview: BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes. At the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners. Please note that this posting is not associated to any specifically available position. As we can hire for this position based on evolving business needs, applicants may be considered for future opportunities. Schedule & Location: Monday Through Friday From 8:30am To 5pm In Varied Time Zones Across Continental United States. It is anticipated that an incumbent in this role will work onsite in Overland Park, KS, Garnet Valley, PA, or Van Nuys, CA. Work hours & location is subject to change based on business needs. Job Description: As a key member of the referral services team, a Referral Specialist will serve as the primary contact to a referral source (prescriber, provider, healthcare center, system, and/or practice), the patient for whom the referral is for, and the field-based sales representative associated with the referral source account. In this role, the Referral Specialist will be responsible for navigating a new prescription via a referral from a referral source through the necessary steps to determine whether it can be serviced in the BioMatrix network of pharmacies. A Referral Specialist will be aligned to a geographic territory of referral sources and corresponding field-based sales team member(s). This role will work closely with data entry, reimbursement, nurse coordination, and pharmacy operations team members supporting various stages of the referral and pharmacy management processes and will understand the referral status and next steps for each referral they are responsible for supporting. The Referral Specialist will build and maintain strong and lasting relationships with key personnel within the referral source environment using effective and timely communication ensuring their patient referrals are managed through service determination in a seamless manner. QUALIFICATION REQUIREMENTS • High school diploma or GED required, • Minimum of one (1) year of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies required, • Minimum of one (1) year of experience providing customer service in health care setting (patients and/or providers), including meeting high quality standards for services and evaluation of customer satisfaction required, • Electronic health medical record or pharmacy patient management experience, • Ability to multitask in a fast-paced environment, • Proficient in medical or pharmacy terminology, written or verbal, • Moderate skills in Microsoft Office (including Word, Excel, PowerPoint, etc.), • Bachelor’s degree preferred, • Minimum of one (1) year of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies preferred, • General understanding of prescription benefits, insurance/payer requirements, and verification processes, • General experience working in a health care setting or services environment, • Build relationships with assigned referral sources and associated BioMatrix field representatives through communication and coordination with key personnel responsible for pharmacy referral activities within the healthcare setting, • Serve as point of contact to referral source and keep necessary referral source personnel well informed of the status of referrals sent to BioMatrix for service, • Follow-up with referral source, patient, and/or caregiver to collect all required information and data sets needed to support the referral process activities (including but not limited to patient demographic, pharmacy/medical benefits, clinical history, and/or prescription details), • Work closely with Reimbursement Specialists and conveys outcomes of benefit investigation activities with patient when it comes to patient out of pocket costs, financial responsibility, and financial assistance options for patient support consideration, • Work closely and communicate with Nurse Coordination team for those patients who intend to move forward with service and require in-home nurse care to be scheduled and organized around prescription fulfillment and shipping, • Work closely and communicate with Pharmacy operations team members ensuring clinical and fulfillment resources have everything they need to successfully support the on-boarding and on-going fulfillment for a new patient referral/prescription, • Produce written documentation representing all provider, patient, caregiver, and/or field team updates and communications in necessary systems of record, • Understand referral turn-around time, volume, and workload metrics and goals established by leadership; use goals to effectively organize referral workload and daily activities for successful outreach and completion of referral steps needed to attain service outcomes/determination, • Support use of technology and other innovative digital channels for internal and external stakeholder communication as directed by leadership; leverage professional and effective communication skills when utilizing technology for written correspondence with these stakeholders, • Have strong understanding of referral and prescription management processes and available services to effectively convey status, outcomes, and next steps to team members as well as referral source, patients, and field resources as expected and needed NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES • Ability to prioritize and handle multiple tasks and projects concurrently, • General knowledge and understanding of referral profitability and reimbursement options related to referral and patient population being served, • Support general administrative activities to navigate patient, provider, and field outreach (i.e. mailings, documentation development, scheduling of meetings/discussions, etc.), • Must have scheduling flexibility and be able to work overtime (from time to time upon request), • Careful attention to detail, • Act as a resource to other departments and participate in department meeting and office presentations with your expertise in this area of referral services, • Performs related duties as requested by leadership, • Participates in quality assurance activities and audits as directed, • Excellent customer service and communication skills (both written and verbal), • Working knowledge of medical terminology, • Ability to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlines, • Ability to complete multiple projects with time sensitive deadlines, • Ability to manage more than one priority project at a time, • Ability to work as part of a team/committee to complete assigned tasks, • Ability to exercise independent judgment and at times, work independently, • Ability to enlist cooperation of other people and department in completing assigned work and projects, • Ability to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services department, • Ability to think and act strategically and proactively, • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetings, • This position requires constant sitting with occasional walking, standing, kneeling or stooping., • This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms., • This position requires constant talking and hearing., • Specific vision abilities required by this job include close vision and the ability to adjust focus., • This position must occasionally lift and/or move up to 20 pounds, • Required to move/lift physical hardware. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People & Culture team at or 954.385.7322 x 1425. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. OTHER • Will participate in legal and ethical compliance training each year., • Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures., • Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual., • Will not participate in any conduct considered to be unethical or illegal. EXPECTATION FOR ALL EMPLOYEES Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins. GENERAL INFORMATION: The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate. Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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