Referral Coordinator - Whole Family Health Center Inc

Job Summary: This person must be able to multi-task and function in a fast-paced environment while contributing to a positive environment for patients and staff and participating in problem solving activities. He or she must be detail oriented, sensitive to the patient’s needs, and require minimal supervision in order to function efficiently. The person in this position maintains office operations by receiving and distributing communications; maintaining supplies and equipment; and serving patients. He or she works directly with the clinical staff and acts as a liaison between the patient and the provider. This position requires close communication with the patient, nurses, providers and case managers in order to coordinate care. This person will coordinate services between WFHC and outside providers. This person assists in keeping the office running efficiently by performing clerical duties, such as answering telephones, photocopying, faxing, and providing quality customer service. Communication with and respect for the patient is essential to build rapport. Good patient assessment skills are essential. This person must prioritize tasks and use space and time efficiently. The person in this position must be able to think critically and logically. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. This is a position of trust.

Communication: Good oral and written communication skills are required for this position. Information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. The ability to communicate in Spanish, Creole, or both is a plus.

Key Responsibilities:

1. Maintain professional behavior, and attitude towards patients, visitors, and co-workers.
2. Schedule diagnostic testing and specialty appointments as requested. Documents in patient’s chart accordingly.
3. Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
4. Ensure complete and accurate registration, including patient demographic and current insurance information.
5. Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.
6. Complete prior authorization process for diagnostics and specialty services.
7. Contact insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and/or physicians.
8. Review details and expectations about the referral with patients.
9. Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
10. Ensure that referrals are addressed in a timely manner.
11. Remind patients of scheduled appointments via mail or phone.
12. Follow up on referrals to ensure patients are keeping the appointments as scheduled.
13. Request medical records/reports and tracks to ensure that records/reports are received in a timely manner.
14. Ensure that patient’s chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
15. Document patient contact and progress in the EHR.
16. Attend educational offerings as appropriate.
17. Perform other duties and responsibilities as assigned.
18. May occasionally need to travel from one location to another for coverage.

Education & Training:

1. High School diploma or GED required, college degree preferred.
2. Must be cross-trained in electronic medical records, scheduling software and Microsoft Outlook.

Experience:

1. One to three years of progressive work experience in a medical office setting

Requirements:

1. Level 2 background clearance required
2. Must have all necessary vaccinations and a PPD test upon hired