Lead, Referral Coordinator

4 weeks ago

Inglewood, United States Martin Luther King Jr. Community Hospital Full time

If interested in position, please apply and send your resume to PBaker@mlkch.or g

POSITION SUMMARY

The Referral Coordinator guides patients through the healthcare system by providing education, assisting with accessing community resources, developing relationships with service providers, and tracking interventions and outcomes. The position is responsible for empowering patients to address and resolve obstacles to health. Referral Coordinator will research, collect, and disseminate accurate information regarding specialty and diagnostic services in the area and assist patients with referrals to other agencies.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Lead Referrals Coordinator

  • Processes all subspecialty and diagnostic referrals and communicates with outside specialty care, diagnostic agencies, and IPA/health plans (if applicable) to initiate referral until appointment is obtained.
  • Notifies patients of appointment times, educates them regarding significance of specialty/diagnostic appointment, provides reminder calls, and assists patients with their appointments.
  • Tracks status of referrals on ongoing basis and if assigned, maintains referral log including, at a minimum: specialty, date of referral, date of appointment, date patient notified, show/no-show status, date specialty consult note received by MLK CMG, and date consult note reviewed/signed by MLK CMG provider.
  • Documents and maintains accurate records for all client encounters including phone encounters and correspondence.
  • Prepares and submits monthly reports of activities as requested.
  • Ensures that referrals are addressed in a timely manner.
  • Researches and updates outside referral sources on an on-going basis.
  • Serves as a liaison between patients and medical staff for both internal and external services.
  • Reviews patient charts prior to releasing to requesting provider/department for needed forms and reviews prior to completion; replenishes forms as needed. Returns records to providers for completion when indicated.
  • Ensures complete and accurate registration, including patient demographic and current insurance information.
  • Contacts review organizations and insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians.
  • Reviews details and expectations about the referral with patients.
  • Works aggressively with physicians and physician office staff to obtain necessary medical information relating to the referral.
  • Meets or exceeds Referral Department productivity targets on a weekly basis.
  • Demonstrates initiative, motivation, and resourcefulness in day to day operations.
  • Attends any meetings as directed by management. Meetings may be held at other outside facilities.
  • Works in conjunction with supervisor when Manager is on PTO or any absence to manage referrals/authorizations across practices.
  • Responsible in training/orientation of new employees on managing incoming and outgoing referrals
  • Participates in continued educational/informational meetings/seminars and provide summary or training to Referral Coordinators.
  • Performs other duties as assigned.
Referrals Management Training
  • Responsible for providing standardized orientation, training, and competency for new clinical employees and students in the clinic setting using established resources and tools.
  • Conducts on-site personal instruction and direction to other employees regarding referrals/authorizations
  • Coordinates training schedule with the department manager, assigning student to other staff or other departments to enhance learning experience
  • Demonstrates patient care and workflow management
  • Advises and assists trainees in achieving stated orientation objectives
  • Evaluates orientation and training resources/material and provides feedback to management regarding effectiveness and suggestions for improvement
  • Provides weekly performance updates to the department manager on referral coordinators and referral KPI
  • Teaches the new clinical employees how to become proficient using the referrals management, insurance portals and EMR system while adhering to Standardized Workflows.
  • Act as a Super User in the EMR system, attends Super User meetings, and trains staff on how to efficiently use the system.
  • Assists management by monitoring and coaching all new employees on referrals/authorizations giving regular feedback to the Manager until they are successfully completed orientation.
POSITION REQUIREMENTS

A. Education
  • High School diploma or GED.
  • At least (1) year experience with patient referrals.
B. Computer Knowledge
  • Proficient in Microsoft Office including Outlook, Word and Excel.
C. Qualifications/Experience
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
  • Strong customer service focus with effective verbal and written communication skills.
  • Minimum of (1) year experience with patient referral process.
  • Knowledge of managed care plans and requirements.
  • Knowledge of CPT and ICD codes.
  • Knowledge of state and county programs including eligibility requirements.
  • Must be Internal employee and in good standing.
  • Active demonstrate leadership qualities to foster a positive working environment

#LI-PB1

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