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Job Summary

The Referral Specialist position plays a vital role in ensuring seamless referral delivery to patients for our Occupational Health program. This position is responsible for managing daily workers’ comp referrals placed through Epic. The Referral Specialist will support patient care coordination of all workers’ compensation referrals by working closely with center staff, adjusters, specialists, and patients. The role also serves as a key escalation point, providing timely troubleshooting and resolution to referral concerns, ensuring a high-quality experience and strong client relationships.

Qualifications

Education Required: • High School Diploma

Work Experience Required: • 2+ years of workers’ compensation referral experience • 1+ year experience working in a GoHealth center • Healthcare experience as an MA or front desk team member

Preferred Qualifications, Education, Licenses, Certifications, Experience, etc.:

• Bachelor’s degree

Knowledge, Skills, and Abilities

• Knowledge of medical office management systems and procedures. • Excellent time management skills and ability to prioritize work. • Strong customer service skills with a commitment to delivering a positive customer experience • Strong written and verbal communication skills for interacting with patients, customers and internal teams. • Highly organized with effective planning skills. • Skilled in Microsoft Office Suite (Excel, Outlook, Word, etc.) • This role involves interaction and collaboration with other departments and requires excellent judgment and interpersonal skills.

Essential Duties and Responsibilities

• Provide customer service support and resolution for urgent issues that arise with workers’ comp referrals, including employers, insurance adjusters, and internal customers. • Work with patients, employers, external specialty groups, and adjusters to process and schedule workers’ compensation referrals for patients. • Obtain claim information for workers’ compensation referrals as needed by contacting patient, employer and insurance adjuster. • Maintain strong relationships with local adjusters and specialty groups for referrals. • Answer patient questions regarding the delivery of their care and keep them informed of their status. • Answer phone calls regarding workers’ comp questions. • Conduct courtesy callbacks for patient follow-up as needed. • Complete other projects as needed such as generating reports, updating forms, supporting customer service needs and other Growth team needs. • Escalate client issues to direct leader as needed.

GoHealth Core Values

GoHealth’s Core Values, listed below, are essential functions of this position:

• Collaboration: Takes ownership for collectively establishing productive partnerships and relationships and seek to gain joint understanding of priorities and objectives so that the greater good of the organization and those we serve is always at the forefront.

• Innovation: Consistently uses good judgment, applying creativity to overcome obstacles and increasing effectiveness and efficiency through process and other forms of innovation.

• Diversity & Inclusion: Fosters diversity and inclusion, to be able to better understand team members, our customers and partners. Engages the strengths and talents of each GoHealth team member, creating an environment of involvement, respect and connection where the richness of ideas, backgrounds and perspectives are harnessed.

• Courage & Integrity: Models and practices the highest ethical and professional standards; demonstrates pride and personal interest in our patients, partners and fellow team members, deeply engaging in the business. Makes decisions, with a focus on doing the right thing; treats team members, our customers, partners and vendors with dignity, consideration, open-mindedness and respect.

• Accountability: Always shows initiative, demonstrates a bias to action and gets things done. Actively accepts responsibility for diverse roles, obligations and actions that positively influence patient and customer outcomes, our partnerships and the healthcare needs of our communities. Physical Requirements

• Office Environment: Tasks may be conducted within a climate-controlled office setting.

• Physical Activity: The role may require the ability to lift, carry, push, or pull materials, supplies, and equipment (up to 25 lbs.) Duties typically involve a combination of sitting, standing, and walking, with frequent changes in position.

• Travel: Travel may be required, including travel between Company locations and out-oftown destinations as needed. Up to 10% of travel, only as needed. • Safety Equipment: May require the use of safety equipment for infection prevention

Note: This Job Description is not inclusive of all the duties of the position. You may be asked by Leaders to perform other duties. Leadership may revise this job description at any time.

Equal Employment Opportunity Statement

The Company and its affiliates, joint venture partners and entities under common management are Equal Opportunity Employers. They do not discriminate based on race, color, religion, national origin, age, sex, disability, veteran status, sexual orientation, gender identity, or any other protected status under federal, state, or local law.

ADA Accommodation Statement Reasonable accommodations are available for qualified individuals with disabilities upon request. This role defines success by achieving essential function outcomes, not by the method of completion.

Compliance Statement This job will be performed consistent with ADA, FMLA, FLSA, and other applicable federal, state, and local laws regulating employment.

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All qualified persons are granted an equal opportunity for employment without regard to race, color, religion, sex, sexual orientation and gender identity or expression, age, national origin, citizenship status, disability, genetic information, medical condition, family care leave status, pregnancy or pregnancy-related condition, otherwise qualified disabled or veteran status. The company will comply with all fair employment laws in each of the jurisdictions where we conduct business.

For applicants in California, please review our California Consumer Privacy Statement here. https://www.gohealthuc.com/privacy-policy