HEALTH INFORMATION AND REFERRAL COORDINATOR - Marimn Health

Come work for Marimn Health - voted one of the Best Places to Work in the Inland Northwest every year since 2018 and Modern Healthcare's Family Friendliest Employer in 2020!

Fantastic benefits, flexible schedules, paid holidays and ability to choose vacation times!

Your employer paid benefits include:

• Medical, Dental, Prescription, and Vision for employee and all legal dependents.
• 401(k) plan with 5% employer match after 1 year of employment.
• Employer paid life insurance.
• Short and long term disability.
• Generous PTO with the ability to earn additional personal days.

Please note that this position is in Plummer, ID. Carpool opportunities are available.

QUALIFICATIONS:

High school diploma or GED required. A minimum of two years’ experience working with insurers, specifically a working understanding of benefits and prior authorization procedures required. A minimum of one year experience in developing and amending work flow procedures required. Ability to work collaboratively across multiple departments required. Knowledge of medical terminology required. Medical coding preferred. AA degree in healthcare related field preferred. Experience with medical authorizations preferred. Electronic Health Record experience required. Good work history indicating: positive work attendance; ability to work well with public and in a team oriented environment; providing excellent customer service both on the phone and in person.

ADA ESSENTIAL FUNCTIONS:

• Hearing: within normal limits with or without use of corrective hearing devices.
• Vision: adequate to read 12-point type with or without use of corrective lenses.
• Must be able to verbally interact with staff, clients and public.
• Manual dexterity of hands/fingers for writing and computer input.
• Able to lift up to 30 lbs.
• Standing/walking 10 - 50% of the day.
• Sitting 50 - 90% of the day.
• Pushing up to 30 lbs.
• Pulling up to 30 lbs.

RESPONSIBILITIES:

• Knowledge of specific information needed for consult, procedure (CT, US, MRI, etc.) and asks specific questions related to procedures (any metals in body, meds, HT, WT., etc.)
• Route documents related to referral to appropriate source, both internally and externally.
• Communicate progress regarding referral to the patient, including timely notification of completion of processes
• Maintain appropriate knowledge of medical coding regarding common procedures and/or illnesses referred.
• Maintain appropriate knowledge of pre-authorization requirements. Collect and provide information related to pre-authorization appropriately.
• Maintain appropriate knowledge of insurance requirements, including knowledge regarding which consults, procedures and/or treatments require pre-authorization.
• Review and understand regulations regarding HIPAA and implications of violations in delivery of services.
• Maintain appropriate documentation regarding all follow-up services required, including whether the appointment was completed.
• Ensure consult notes and test results are filed and documented appropriately in the chart.
• Work closely with PRC, Outreach worker, Insurance Specialist, and Providers to ensure all referrals are processed properly.
• Work closely with the Outreach worker and Insurance Specialist to help patients apply for Health Benefits and access existing programs available.
• Maintain appropriate knowledge of resources and services available for patients without insurance.
• Complete all tasks associated with follow-up of referrals and results related to Women’s Health program and Susan B. Komen program, including routing timely routing of test results.
• Maintain close monitoring of patient flow and works closely with medical staff to exchange information in expediting patient visits.
• Answers all incoming calls to the Health Information department and routes to appropriate person, employee or department.
• Follows up on telephone tasks that have not been accepted.
• Responsible for quality assurance of all medical records and releases; keeping records updated and archived according to company standards.
• Collects all clinical information in the return to Health Information file daily.
• Responsible for reviewing, extracting and data entry of pertinent health information from outside records into patient’s Electronic Health Record.
• Responsible for making sure all documents are appropriately scanned within patient charts. Documents are scanned into ICS into correct patient and document type. Assure scanning is completed in a timely manner with appropriate signatures and details required to be complete prior to scanning.
• Ensures filing of internal miscellaneous documents are completed within 72 hours of receipt in the medical records department.
• Ensure all outside facility documents (hospital, imaging centers, doctor’s offices etc are pushed through provider’s PAQ and is scanned in within 24 hours (business day) of receiving the document.
• Assists patients in requesting medical records according to departmental policy. Assures that requests are filled out correctly and signed.
• Handles all releases of information required for referrals or patients, copies of immunization records and/or physical exam forms.
• Responsible for making sure all documents are appropriately scanned within patient charts. Documents are scanned into ICS into correct patient and document type. Assure scanning is completed in a timely manner with appropriate signatures and details required to be complete prior to scanning.
• Processes all medical record requests/ (ROI’s) and routes the information to the requested parties within 7 days of receiving the request when applicable, prepares invoices to the appropriate payer for payment of requested records. Processes all outgoing and incoming mail for the department. Responsible for sorting and directing mail to the appropriate employee per policy.
• Assists in securing, archiving, and storing of all medical records.
• Assists in meeting all medical records HIPAA compliance regulations.
• Other duties as assigned

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