ECM Referral Specialist
4 weeks ago
Who we are:
We are a healthcare company that puts heart and compassion above all else. Millions of Americans just aren’t getting the medical care they need. We’re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost.
Join us in our mission
Job Summary: The ECM Referral Specialist plays a crucial role in facilitating the seamless transfer of patients between healthcare providers and ensuring that patients receive appropriate care in a timely manner. This position involves coordinating referrals, obtaining necessary authorizations, and communicating with patients, healthcare providers, and insurance companies to ensure smooth transitions of care.
Position Responsibilities:
- Review referral requests to assess the appropriateness of referrals based on ECM criteria.
- Obtain necessary patient information and medical records to support referral requests.
- Coordinate referrals with Titanium staff, hospitals, facilities, shelters, and other healthcare entities as needed.
- Verify insurance coverage and upload necessary documents to eClinicalWorks.
- Communicate with patients to schedule appointments, provide referral information, and address concerns or questions.
- Maintain accurate and up-to-date records of referral activities, including documentation of communication with patients and healthcare providers.
- Collaborate with Titanium clinical staff, including nurses and physicians, to complete internal referrals to ECM.
- Monitor referral status and follow up on pending referrals to ensure timely completion.
- Assist with resolving any issues or barriers that may arise during the referral process, such as insurance denials or document requests.
- Stay informed about changes in ECM criteria, referral policies, and healthcare services that may impact the referral process.
Position Requirements:
- High school diploma or equivalent required.
- 1+ year minimum experience in a healthcare or social service setting in a role involving referral coordination, care management, or outreach.
- Strong communication skills, both written and verbal, with the ability to effectively interact with patients, healthcare providers, and insurance companies.
- Excellent organizational skills and attention to detail to ensure accurate documentation and timely completion of referrals.
- Proficiency in computer applications, including electronic health record systems, scheduling software, and Microsoft Office.
- Ability to work independently and prioritize tasks in a fast-paced environment.
- Commitment to maintaining patient confidentiality and adhering to ethical standards in healthcare practice.
Preferences (not a requirement for the role):
- Associate or bachelor's degree in healthcare administration, business administration, or related field preferred.
- An equivalent combination of education and experience that provides the skills, knowledge, and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
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