Lead Referral Coordinator

Job Title: Lead Referral Coordinator

Job Summary:

We are seeking a highly skilled and experienced Lead Referral Coordinator to join our team at WellSpace Health. The successful candidate will be responsible for providing expertise and guidance to a team of referral coordinators in organizing the day-to-day referral process, ensuring the appropriate use of standards.

Responsibilities:

* Plans, organizes, directs, and coordinates the operations of the referrals team.
* Provides oversight of daily operations for the department, including metrics, performance, and reporting.
* Leads regularly scheduled team meetings.
* Maintains ongoing tracking and appropriate documentation on referrals to promote team awareness and ensures patient safety using the EHR system.
* Assists staff to handle work volume and issues, in accordance with the organization's policies and procedures.
* Mentors, directs, and trains staff to ensure that work is carried out in a structured manner.
* Coordinates the upkeep of the referral tracking systems used.
* Proficiently tracks and records reports in the EHR.
* Reviews details and expectations about the referral with the patient, and is the point of contact for patients on referral submission progress and updates.
* The Lead Referral Coordinator may also schedule referral appointments directly on behalf of the patient.
* Answers inquiries from clinical teams and patients, provides information, and resolves complaints from the public or other agencies in regards to referrals.
* Ensures that referrals are processed in a timely manner.
* Reviews status on Treatment Authorization Request (TARs) and any other authorizations, requirements of Managed Care Organizations to assure compliance with health plan programs.
* Follows-up on pending referrals, reviews, and manages the tracking system.
* Responsible for referral report management and reporting to management.
* In coordination with the Referral Supervisor, audits information entered in the EHR to ensure compliance with capturing necessary data as required by reporting agencies patients.
* Investigates difficult cases; primary contact for patient's or provider's inquiries/concerns in obtaining appropriate care for the patient.
* Utilizes EHR functions to document all pertinent information.
* Assists with daily scheduling for referral volumes and adherence to patient and/or client/organization overall service level agreements (SLA).
* Ensures all tasks, emails, correspondences, research functions are handled in conjunction with SLA and compliance standards.
* Identifies trends and escalates issues to manager timely to minimize the organization risk, enhances the patient/client experience, and adherences to root cause policies and procedures.

Requirements:

* High School Diploma or equivalent.
* Medical Assistant training/certification preferred.
* At least two years' experience in medical referrals.
* Excellent communication skills (oral and written) including the ability to communicate effectively with employees, patients, and providers over the phone, in email, and other communications.
* Strong customer service experience including active listening, problem solving, and the ability to remain calm in emotional or stressful situations.
* Ability to maintain detailed records.
* Ability to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline.
* Ability to use standard office equipment including phone, fax, computer.
* Proficient in Microsoft Office, NextGen, and EPIC electronic health record system (EHR) preferred.
* Thorough understanding of medical terminology, payer sources, insurance, and program requirements.
* Ability to maintain patient confidentiality and adhere to HIPAA regulations.
* Ability to work flexible schedule when needed.
* Demonstrated ability to effectively problem solve and knowledge of leadership practices and principles, including work planning, scheduling, reviewing, and training.
* Attention to details and ability to work independently and as a team player.
* Able to take and follow through with delegated tasks and accountability.
* Demonstrated commitment to the provision of care services for the underserved.
* Demonstrated ability and sensitivity working with a variety of people from low-income populations, with diverse educational, lifestyle, ethnic, and cultural origins.
* Adherence to infection control procedures, including but not limited to, standard precautions of temperature monitoring, hand washing, symptom self-monitoring, masking, and social distancing.

Benefits:

* Regionally competitive salary.
* Above-average health benefits at reduced costs.
* Company-paid life insurance and long-term disability insurance.
* Additional voluntary retirement plan with company match and no vesting schedule requirement.
* Paid bereavement and jury duty leave.
* 11 paid holidays per year.
* Paid time off.
* Paid sick leave.
* Flexible Spending Program.
* Company-paid malpractice insurance for all providers.
* Professional development hours offered annually.

Work Environment:

The work environment is characteristic of a medical clinic environment. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle, or feel. The employee is also required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment is usually quiet. The employee may be in contact with individuals and families in crisis who may be ill, using substances, and/or not attentive to personal health and safety for themselves or their homes. The employee may experience a number of unpleasant sensory demands associated with the client's use of alcohol and drugs, and the lack of personal care. The employee may also be exposed to bodily fluids (blood, urine) and hazardous chemicals. WellSpace Health is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is the intent of WellSpace Health to maintain a work environment free of harassment, discrimination, or retaliation because of age, race, religious creed, color, national origin, ancestry, physical disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding, and/or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by federal, state, or local laws. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. WellSpace Health is an Equal Opportunity Employer.

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