Referrals Coordinator

2 days ago

Batavia, Illinois, United States SOS International LLC Full time
Job Summary

We are seeking a highly skilled Referrals Coordinator to join our team at SOS International LLC. As a Referrals Coordinator, you will play a critical role in processing government customer medical referrals for off-site medical appointments.

Key Responsibilities
  • Prepare, update, and maintain medical referral information for each patient, ensuring accuracy and completeness.
  • Support the outside provider recruitment process as liaison between providers and government customers.
  • Maintain a system of records for tracking purposes and reference in support of the Provider Network.
  • Coordinate the purchase or rental of durable medical equipment for detainees in custody.
  • Contacts off-site community medical providers to schedule appointments for specialty care based on provider referrals and documents specific appointment dates in the eHR.
  • Tracks compliance with scheduled patient appointments, making timely reminder notices or calls to off-site facilities and government customer staff.
  • Coordinates transportation with custody transport staff for scheduled off-site medical appointments and creates sealed medical packets for patients.
  • Files/scans laboratory, radiology, and other reports in the electronic medical record upon patient return.
  • Routes clinical reports to appropriate clinic staff within prescribed timelines.
  • Corresponds with off-site medical facilities and Provider Network providers to request pertinent medical information.
  • Tracks requests and performs follow-up to ensure receipt of requested information.
  • Handles all correspondence requiring authorizations for payment of medical services.
  • Reviews documentation for completeness and routes incomplete documents to the appropriate provider for correction.
  • Receives and processes requests for information in accordance with the Fair Information Practice Principles and Privacy Act.
  • Utilizes multiple systems to process narrative and tabular material to prepare, update, and maintain medical records and provide required information to medical personnel.
  • Completes reports to ensure accurate referrals before transmission to the VA system for payment and corrects any errors found.
  • Assists in reconciling and resolving denied outside provider claims.
  • Performs record-keeping functions in accordance with program policies and position.
  • Maintains functional proficiency and ease of use with electronic health records and referrals.
  • Completes and passes all Referrals Coordinator competencies, initially and annually.
  • Completes all initial, annual, and ad-hoc training as required/assigned.
  • Serves as a team member for analyzing established protocol practices and identifying areas for improvement.
  • Maintains patient confidentiality and confidentiality of medical records in compliance with the Privacy Act and HIPAA regulations.
  • Adheres to and maintains awareness of policies, procedures, directives, operational memoranda, and accreditation standards as prescribed by the customer.
  • Adheres to and participates in safety, quality improvement, and other programs and collateral duties as appropriate to position.
  • Attends and participates in general/medical staff meetings.
Requirements
  • High School Diploma or GED equivalent.
  • Minimum of one-year experience in a healthcare setting as a medical record technician, medical record clerk, unit secretary, or similar position.
  • Ability to obtain/maintain required security clearance.
  • Ability to obtain/maintain pre-employment medical clearance.
  • Knowledge of basic principles and standards of eHR procedures and methods.
  • Knowledge of documentation requirements, timeliness of referral management, and knowledge of eHR workflow to process electronic medical referrals and records.
  • Basic fluency of medical terminology.
  • Administratively processes medical referrals for off-site medical appointments.
  • Schedules off-site specialty consults and follow-up appointments.
  • Requests and uploads medical records to the electronic Health Record (eHR).
  • Recognizes documentation inconsistencies in referrals within the eHR ensuring compliance and resolution.
  • Knowledge of Current Procedural Terminology (CPT) codes.
  • Ability to work in a multi-cultural environment.
  • Ability to work approximately 90% of time using a computer, telephone, scanner, and printers.
  • Ability to utilize telephonic interpreter/translation services to complete assigned duties if not fluent in a language the patient understands.
  • Ability to adapt to sudden changes in schedules and flexibility in work requirements.
  • Ability to communicate proficiently in English (verbal and written) in order to develop positive rapport with patients, co-workers, and other stakeholders.
  • Ability to establish and maintain positive working relationships in a multidisciplinary environment.
  • Ability to navigate in an electronic work environment including eHR, web-based trainings, and Microsoft Teams application navigation.
  • Knowledge of and functional proficiency in common Microsoft Office programs, specifically Microsoft Word, Excel, Outlook, and SharePoint.
  • Knowledge of regulations (HIPAA/Privacy Act) regarding the confidentiality of patient medical records and information as well as Personally Identifiable Information (PII).
  • Strong communication skills in both verbal and written.
  • Excellent interpersonal skills.
  • Proficient in Microsoft Office (MS Word, Excel, PowerPoint, Outlook, and SharePoint).
  • Maintains Heartsaver CPR AED certification through the American Heart Association.
  • Preferred qualifications include verbal and written proficiency in Spanish and prior experience in a detention/correctional or residential healthcare setting.
Work Environment

The facility operates 24/7/365, and employees may be required to respond during emergency activations. Ability to work non-traditional hours, including evenings, weekends, and holidays, is required. The work requires some physical exertion, such as long periods of standing, walking, or jogging, and recurring bending, crouching, stooping, stretching, reaching, or similar activities. Must be able to respond to any medical emergency in the facility within four minutes and perform CPR/emergency care standing or kneeling.

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