What are the responsibilities and job description for the Referral Coordinator position at Appalachian Mountain Health?

Appalachian Mountain Health (AMH) is a Federally Qualified Health Center (FQHC) that provides comprehensive primary care to low-income, medically underserved and uninsured populations. AMH's mission - to provide culturally competent, high quality healthcare to the medically vulnerable population in western North Carolina - is rooted in a primary care and preventive services medical home model with fees for services adjusted on the basis of a patient's ability to pay.

ESSENTIAL DUTIES & RESPONSIBILITIES

Tracking referrals to ensure they are addressed in a timely manner and monitored until completion; maintaining appropriate documentation in the Electronic Health Record (EHR) throughout the tracking process, including the outcome of the referral
Completing prior approval / authorization requests for medically necessary services and medications, including contacting public and private payers to ensure all requirements for prior approval / authorization have been met
Compiling medical and social history as it pertains to referrals and providing the appropriate information to the referred party
Assisting patients in problem-solving barriers to accessing care and navigating healthcare systems; for example, assisting with transportation, enrolling patients in patient assistance programs and securing interpretation services
Serving as a system navigator and point-of-contact for patients and their families, including, when necessary and appropriate, advocating on the patient's behalf with other providers, healthcare organizations and public and private payers
Working with Project Access, North Carolina Med Assist and other patient assistance programs to ensure access to medication and services and identifying and utilizing community resources with a high degree of cultural competence and patient-centeredness
Establishing and maintaining referral relationships with identified providers and healthcare organizations

ADDITIONAL DUTIES (as needed)

Providing front office coverage, including scheduling appointments, checking patients in and out, collecting and entering or verifying patient demographic information and assessing charges, including past due balances and collection of fees at each appointment (see AMH Front Office Coordinator Job Description)

As appropriate based on education and skill set, assisting the clinical team as a Medical Assistant (see AMH Medical Assistant Job Description)

KNOWLEDGE & SKILLS

Orientation to teamwork

Exceptional customer service skills

Excellent communication skills in person, on the phone and in written communications

Flexibility in a rapidly growing and changing work environment

Resourceful and adept at problem solving

Effective management of multiple duties and responsibilities in a clinical setting

Demonstrates respect, dignity and empathy with patients

Able to take direction, follow through and be accountable for the process and outcomes

Excellent interpersonal skills in group and community settings

Ability to maintain confidentiality of clinical and financial information

Excellent listener

Demonstrates initiative

Requirements

REQUIRED QUALIFICATIONS

High school diploma or General Educational Development (GED)

Basic computer skills, including some familiarity with Microsoft Office products (e.g. Word, Excel, PowerPoint)

PREFERRED QUALIFICATIONS

Satisfactory completion of Medical Assistant Certification Program

Experience working with racially and ethnically diverse populations, low-income populations and people experiencing homelessness

At least one year of experience in a primary care or public health setting functioning at the full extent of her / his training

Fluency in Spanish

PHYSICAL DEMANDS AND WORKING CONDITIONS

Sitting for long periods of time working at a computer

Ability to sustain concentration in a noisy and fast-paced environment

Possible exposure to communicable diseases, biohazards, toxic substances, medicinal preparations and other conditions common to a clinical setting

Some travel within western North Carolina

Compensation will be commensurate with experience and education. The position is full-time (40 hours per week), hourly and not exempt from some provisions of the Fair Labor Standards Act (FLSA). The position will be eligible for benefits (e.g. medical, dental, life, short- and long-term disability, retirement) and report to the Regional Practice Manager or Regional Registered Nurse (RN) Manager.

AMH is an equal opportunity employer. We value a diverse workforce and encourage applications from all qualified individuals without regard to race, color, age, sex, gender identity or expression, sexual orientation, religion, marital status, citizenship, disability or veteran status.

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