REFERRAL COORDINATOR

4 weeks ago

Trussville AL USA, United States Complete Health Full time
Job Description

Pay: $16.00 - $18.00/hr

SUMMARY OF JOB DUTIES:

This position will be responsible for serving as the central access point for referring providers and assisting in meeting key service and financial pillar goals. Utilizes appropriate protocols and resources, critical thinking, and decision-making skills to navigate the patient through service lines to receive care for referred services. Captures patient-level demographics, insurance eligibility, and registration details and authorizations prior to service completion. Tests and refines new technology and workflows within Patient Access Center (PAC) to ensure strategic alignment across service lines and in support of the organization's goals.

ESSENTIAL JOB FUNCTIONS:

  • Serves as the decision-making resource and utilizes critical thinking to analyze the needed coordination for patient care associated across multidisciplinary departments.
  • Facilitates timely and efficient referrals and follow-up with patients for both specialist and diagnostic orders utilizing our Tier 1 and Tier 2 providers, when appropriate.
  • Scheduling appointments when appropriate for our Value Based Care patients within 48 hours of a non-stat referral/order.
  • File and fax referral authorizations as necessary.
  • Verifies insurance eligibility communicating effectively with providers and patients as needed with viable information.
  • Demonstrates a high degree of commitment to customer service and quality care provisions.
  • Maintains effective communication.
  • Aligns to all HIPAA guidelines.
  • Conducts outreach efforts with referring providers to provide status updates.
  • Completes documentation, including demographics and referral information notes and orders.
  • Escalates barriers to scheduling timely care and navigation for patients.
  • Monitors messages from internal partners surrounding patient need according to the level of urgency defined.
  • Exhibits the ability to manage time well and work under stressful circumstances.
  • Ability to manage time clocking in and out appropriately.
  • Participates in PAC departmental workgroups to support continuous improvement in workflows and new technologies.

Requirements

KNOWLEDGE/SKILLS/ABILITIES

  • Must be team-oriented, highly organized, detail-oriented and have successfully demonstrated the ability to manage multiple priorities.
  • Proven customer service skills and the ability to resolve problems and prevent patient dissatisfaction while ensuring quality standards are met.
  • Ability to consistently utilize the appropriate and approved tools and protocols to handle patient calls.
  • Ability to diffuse escalated patient situations and ensure best practices in delivery of service.
  • Entry to intermediate knowledge of MS Office Suite including technical and computer skills.
  • Ability to navigate quickly within various computer programs.
  • Sound verbal and written communication skills, as well as strong listening skills.
  • Problem-solving skills with an ability to think quickly under pressure.
  • Ability to handle high call volume and answer patient questions in a timely manner.
  • Ability to improve accuracy and quality.
  • Ability to work varying shifts including early mornings/evenings and/or weekends to attend meetings and cross training or support other initiatives.
  • Demonstrated ability to maintain confidentiality using tact and diplomacy.

MINIMUM REQUIREMENTS

  • High School Diploma Required.
  • Electronic Medical Record (specifically Athena) experience preferred.
  • Medical experience required.
  • Experience with medical insurance required.
  • Must have working knowledge of the medical referral process and procedures along with minimum of two years of related clinic experience.
  • Must be able to work with minimum supervision.
  • Must have excellent written and verbal skills.

WORKING ENVIRONMENT

The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.

DISCLAIMER

The above statements are intended to describe the general nature and level of work being performed by the Referral Coordinator. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Referral Coordinator may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.

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