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Referral Coordinator

4 months ago

Harwich Port, United States Outer Cape Health Services Full time
Job DescriptionJob Description

Referral Coordinator

Our Culture: Why work with us?

Joining Outer Cape Health Services isn't just about taking on a new role; it's about embracing a mission that goes beyond the day-to-day. Here, you become part of a dedicated team committed to safeguarding and nurturing invaluable community health resources. Our ethos is built on creating a vibrant and inclusive workplace where every team member is valued and recognized for their unique contributions.

Who We Are :

Our mission is to provide a full range of primary health care and supportive social services that promote the health and well-being of all who live in or visit the ten outermost towns of Cape Cod.

OCHS now cares for more than 18,000 patients annually, and no one is denied access to services due to an inability to pay. Founded in 1987 through the merger of Health Associates of Provincetown (established in 1972) and the AIM Medical Center in Wellfleet (established in 1966), Outer Cape Health has a long history of successful growth and expansion in pursuit of this mission. As a Patient-Centered Medical Home, OCHS holds itself to the highest standards. Ensuring patients have access to care when they need it and request it, and validating that staff are working at the top of their licensures, are foundations of this model.

Our Core Competencies:

At Outer Cape Health Services, our core competencies are the foundation upon which our organization is built, guiding us in our mission to deliver exceptional health services to our communities. Our focus on fostering teamwork ensures that we operate as a cohesive unit, valuing each member's contribution and working synergistically towards common goals. Integrity and honesty stand at the heart of everything we do, creating a culture of trust and respect among our team and the communities we serve. Embracing technology, we continually seek innovative solutions to enhance our services and operations. Finally, being patient-centered, we prioritize the needs and well-being of those we serve, striving to exceed expectations and make a meaningful difference in their lives.

A day in the life of this role:

As the Referral Coordinator, where you'll play a crucial role in enhancing patient care within our behavioral health department. In this vital position, you'll assist our healthcare providers and nursing staff by managing a range of support services. Your day-to-day responsibilities will include coordinating appointments, managing referrals, and maintaining patient records. You'll also handle correspondence, prescriptions, and other critical tasks, ensuring the smooth delivery of quality healthcare services to our patients. This role is perfect for someone who thrives in a fast-paced, clinical setting and is passionate about making a difference in the lives of others.

Summary of duties:

  • Provide support to providers and nurses as needed
  • Respond to patient requests and faxes within forty-eight (48) hours utilizing the EMR
  • Prepare and send patient letters as requested by the provider or nurse
  • Prepare prior authorizations for medication as needed
  • Prepare telephone encounters as needed to providers or nurse
  • Schedule patients for clinician-ordered referral appointments
  • Obtain all PCCP approvals as per clinical staff requests as well as ensuring all other referrals are approved prior to patient appointment
  • Review scheduled referral/procedure appointments to ensure patient compliance and completeness of medical records
  • Verify insurance eligibility when scheduling patient's outside appointment; notifies patient and provider if appointment with specialist is not covered by insurance plan
  • Contact no-show appointment patient per behavioral health clinical staff request
  • Assist clinical staff in obtaining other necessary services for behavioral health patients such as community services, transportation, etc.
  • Seek the assistance of Certified Applications Counselors if necessary
  • Maintain patient confidentiality and observes HIPAA regulations at all times
  • Maintain and updates patient records, which may include information from other care providers, detailed information on procedures and tests conducted within the office, and records of patient ailments and treatments
  • Work with patients to arrange follow-up appointments, send reminders, and provide information about referral appointments
  • Type, file and perform other related clerical work as required, or assigned
  • Assist in maintaining statistical data and performing Quality Assurance audits as assigned
  • Track visits and authorization time limits in coordination with billing department
  • Ability to assist during peak clinical hours with other job duties as needed to ensure overall

What we need from you:

  • Graduation from high school, or the equivalent
  • 6 months' office experience, including extensive public contact

Preferred Qualifications, Education, and Experience

  • Experience in health care setting

Core Competencies

Specialized Knowledge

  • Medical terminology
  • EMR
  • Insurance product knowledge
  • Insurance referral process knowledge
  • Problem resolution
  • Computer application skills, including Microsoft Windows, Word and Excel

Communication

  • Good oral and written communication
  • Cross-functional communication

Interaction and Collaboration

  • Building/strengthening collaborative relationships (both internal and external stakeholders)
  • Building trust
  • Teamwork: ability to work across multiple functions and disciplines collaboratively

Time Management

  • Skilled at organization
  • Ability to handle multiple tasks simultaneously
  • Ability to prioritize Ability to handle high volume of referrals at once

AAP/EEO Statement Outer Cape Health Services is committed to a firm policy in favor of equal employment opportunity and will abide by all applicable state and federal regulations by not discriminating against any applicant or employee on the basis of race, religion, color, creed, sex, age, national origin, citizenship status, marital status, sexual orientation, gender identity and expression, disability or veteran status. Our commitment to equal employment opportunities shall include employment, upgrading, promotion, demotion, transfer, leaves or other absences from work, layoff, compensation and benefits, selection for training or other education, professional opportunities and conflict resolution.

It is also the policy of OCHS to take affirmative action to employ and to advance in employment, all persons regardless of their status as woman, minority or individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.

Please inform us of any necessary accommodations required during the application process and/or at any time during employment.



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