Description

Position Overview:

Ensure that referrals for off-site specialty appointments and diagnostics are routed, scheduled and reconciled in accordance with the Network’s referral management policy and procedure. This work is carried out in support of the mission and goals of Ryan Network.

Essential Functions:

1. Review assigned diagnostics and referral consult, i.e. “Jelly Bean” in e-Clinical Works, the electronic health record.
2. Ensure appropriate specialty referral form has been initiated and all required information provided, including number of visits and expiration date of the referral.
3. Fax referral form and supporting documents (i.e. progress note, radiology reports, laboratory results) attached by the practitioner to off-site specialists.
4. Obtain prior authorization for specialty visits when required by patient’s insurance carrier.
5. Schedule appointments to appropriate off-site specialist as per the practitioner’s note or patient’s preference.
6. Document specialty appointment date, time and location in the patient’s electronic health record (EHR).
7. Maintain assigned referrals in accordance with the Network’s referral management policy and procedure.
8. Process, monitor, and reconcile urgent/STAT/high-risk referrals.
9. Ensure appointments for urgent/STAT/high-risk referrals are scheduled in accordance with the timeframe specified in the Network’s referral processing and tracking policy and procedure.
10. Monitor urgent/STAT/high-risk specialty appointments to verify patient attended the appointment.
11. Obtain consultation reports from specialty providers to reconcile and address urgent/STAT/high-risk referrals.
12. Review monthly report of all urgent/STAT/high-risk referrals to track metrics related to the timeliness of processing and addressing referrals.
13. Maintain and update incoming referrals to ensure that all off-site appointments are scheduled.
14. Document status of off-site specialty appointments in patient’s Electronic Health Record.
15. Contact patient with appointment information via the patient’s preferred method of contact.
16. Print and mail completed referral form to patient.
17. Call patient with appointment information when appointment date is within five business days or less.
18. Assist the Patient Services Department as needed.
19. Immediately report any problems and/or unusual circumstances to supervisor.
20. Other duties and/or projects as assigned.

Qualifications

Minimum Experience and Skills Required:

• Minimum two (2) years of work experience in patient services or related field.
• Experience in a customer service environment.
• Strong organizational skills and attention to detail.
• Strong communication, interpersonal, and customer service skills.

Education, Licenses and/or Certifications Required:

• High school diploma or equivalency.

Preferred Qualifications:

• Advanced degree.
• Prior experience in a multi-site Federally Qualified Health Center (FQHC) or other health care environment.
• Bilingual: English/Spanish or any other language

Competencies Required:

Customer Service:

• Professional, courteous and respectful attitude in dealing with others.
• Commits to exceeding expectations of the patient.

Cooperation/Teamwork

• Works well with others.
• Contributes input to improve outcomes.
• Asks others for opinions and feedback; provides feedback in a tactful respectful way.

Minimal Training Time:

Probationary period consisting of three months of actual workdays.

Working Conditions:

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to sit, stand, talk and hear.

The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment.

Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work is performed in an office and in outreach settings. The noise level and space accommodations in the work environment may vary.

Disclaimer

The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.

Equal Opportunity Employer

Ryan Network is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.