Referrals Coordinator

2 days ago

Elizabeth, New Jersey, United States SOS International LLC Full time
Job Title: Referrals Coordinator

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 customer.
  • 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.
  • Contact off-site community medical providers to schedule appointments for specialty care based on provider referral and document specific appointment date in the eHR.
  • Track compliance with scheduled patient appointments, making timely reminder notices or calls to the off-site facility and government customer staff prior to each appointment.
  • Coordinate transportation with custody transport staff for scheduled off-site medical appointments and create sealed medical packets for patients.
  • File and scan laboratory, radiology, and other reports in the electronic medical record upon patient return from off-site visit.
  • Route clinical reports to appropriate clinic staff within prescribed timelines.
  • Correspond with off-site medical facilities and Provider network providers to request pertinent medical information for the medical record.
  • Track requests and perform follow-up to ensure receipt of requested information.
  • Handle all correspondence requiring authorizations for payment of medical services.
  • Review documentation for completeness and route incomplete documents to the appropriate provider for correction prior to placing/scanning in the medical record.
  • Receive and process requests for information in accordance with the Fair Information Practice Principles and Privacy Act.
  • Utilize multiple systems to process narrative and tabular material to prepare, update, and maintain medical records and provide required information to medical personnel.
  • Complete reports to ensure all referrals have been completed correctly before transmission to the VA system for payment and correct errors found.
  • Assist in reconciling and resolving denied outside provider claims.
  • Perform record-keeping functions in accordance with program policies and position.
  • Maintain functional proficiency and ease of use with electronic health records and referrals.
  • Complete and pass all Referrals Coordinator competencies, initially and annually.
  • Complete all initial, annual, and ad-hoc training as required/assigned.
  • Serve as a team member for analyzing established protocol practices and identifying areas for improvement.
  • Maintain patient confidentiality and confidentiality of medical records in compliance with the Privacy Act and HIPAA regulations.
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 where processing of electronic medical/health records was part of daily responsibilities.
  • 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 process medical referrals for off-site medical appointments.
  • Schedule off-site specialty consults and follow-up appointments.
  • Request and upload medical records to the electronic Health Record (eHR).
  • Recognize 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) 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).
Preferred Qualifications:
  • Verbal and written proficiency in Spanish is preferred.
  • Prior experience in a detention/correctional or residential healthcare setting is preferred, not required.
Work Environment:

The facility operates 24/7/365, and an employee may be required to respond during an emergency activation. Ability to work non-traditional hours, including evenings, weekends, and holidays. Night shifts may be requested at times based on mission needs but are generally not required. The work requires some physical exertion, such as long periods of standing, walking, or jogging unaided over rough, uneven, or rocky surfaces. Must be able to respond to any medical emergency in the facility, via foot, within four minutes and perform CPR/emergency care standing or kneeling.

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