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Telehealth Clinical Referral Coordinator

2 months ago

Columbia, United States The Cigna Group Full time

Position Description

The Referral Coordinator is part of the telehealth clinical team, which is devoted to the delivery of health care in an online and fast-paced setting. The Referral Coordinator will work in a role that supports the healthcare team and the patient by anticipating, facilitating, managing, and responding to patient referral and authorization needs and requests of the healthcare team. The Referral Coordinator's activities complement the team-based care delivery model. Strong customer service, communication, and computer skills are required. This position will work five eight-hour shifts Monday-Friday between the hours of 9AM-9PM EST. Scheduled days and hours will vary based on business needs. While the organization will do its best to keep you in your desired schedule, schedules are subject to change, or you may be required to 'float' to support other service lines based on business needs.

Essential Job Functions

  • Support the clinical and administrative operations of telehealth across practice settings primarily focusing on referral coordination.

  • Receive, review, process, and track incoming patient referrals from various sources.

  • Collaborate, facilitate, and orchestrate patient care and referral coordination across various healthcare providers and services.

  • Accurately document and update patient information in the electronic medical record.

  • Utilize multiple forms of technology and platforms in the delivery of patient care.

  • Organize and track referral processes and patients need for optimal outcomes.

  • Facilitate clear and timely communication between patients and the healthcare teams.

  • Obtain preauthorization for services as required.

  • Pull reports, track, trend, and maintain organized and up-to-date referral records in the electronic (EHR) system or other designated databases.

  • Advocate for patients' well-being and needs.

  • Identify and report patient safety, compliance, and quality issues.

  • Adhere to all relevant healthcare regulations, policies, and procedures.

  • Provide guidance and training on referral and preauthorization procedures when necessary.

  • Identify and educate the patient on available resources.

  • Other duties as assigned.

Knowledge/Skills/Abilities Should Include

  • Strong work ethic and ability to multi-task in a high-volume and fast-paced environment.

  • Detail-oriented.

  • Problem solving, planning, and referral management skills necessary.

  • Excellent written and oral communication skills

  • Ability to effectively prioritize and simultaneously manage responsibilities and assignments.

  • Strong demonstrated computer literacy.

  • Exceptional customer service, interpersonal, and organizational skills.

  • Ability to work a schedule that may change within the timeframe outlined above

Education and Experience Should Include

  • High school diploma

  • Two or more years of experience as referral coordinator.

  • Proficiency in Excel/Smartsheet's/Google Sheets

  • Experience with Availity for referral management and healthcare transactions.

  • Knowledge of medical terminology, insurance procedures, and healthcare systems

  • Proficiency in using electronic health records (EHR) and other healthcare-related software.

  • Critical thinking skills and an initiative-taking approach to resolving issues.

If you will be working at home occasionally or permanently, the Internet connection must be obtained through a cable broadband or fiber optic Internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: (see below) for support. Do not email (see below) for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.