HIM Referral Tech I

This position is to support patients and staff in the coordination of care to outside specialty offices and services. In addition, this position will process referral orders, schedule appointments, communicate the appointment date and time to the patient, and insure the appropriate documentation is sent to the receiving facility. Track referrals to completion. Collect results, document in the electronic medical record and notify the provider.

Job Specific Competencies
1. Consistently demonstrates appropriate and professional communication with patients and customers.
2. Efficiently uses EMR software to perform all aspects of referrals management including managing work queues.
3. Demonstrates proficiency and accuracy in all aspects of referrals management.
4. Assists in the coordination of care by reviewing and processing all referrals in a timely manner to ensure continuing medical care.
5. Identifies STAT referrals and processes them immediately.
6. Obtain prior authorization from payers, as needed.
7. Schedules appointments for patients, as needed, and in collaboration with the patient.
8. Places calls and answers patient specialty office calls to facilitate successful patient scheduling.
9. Manages calls from patients, insurance companies, internal staff and providers.
10. Track all referrals written to specialists and/or facilities through completion; including uploading reports of completed referrals and routing to provider.
11. Communicates with providers regarding incomplete or denied referrals.
12. Data management which includes tracking metrics

General Duties and Responsibilities

1. Performs other duties and tasks as assigned by supervisor.
2. Expected to meet attendance standards and work the hours necessary to perform the essential functions of the job.
3. Conforms to safety policies, general housekeeping practices.
4. Demonstrates sound work ethics, flexible, and shows dedication to the position and the community.
5. Demonstrates a positive attitude, is respectful, and possesses cultural awareness and sensitivity toward clients and co-workers.
6. Keeps customer service and the mission of the organization in mind when interacting with all clients, co-workers, and others.
7. Employees are expected to embrace, support and promote the core values of respect, integrity, trust, compassion and quality which align with the CVCH mission statement through their actions and interactions with all patients, staff, and others.
8. Conforms to CVCH policies and Joint Commission and HIPAA regulations

Education
High School Diploma or equivalent. Associate degree preferred. Medical Terminology preferred.

Certifications/Licensure
NA

Experience
One year of experience in the medical field, Health Information Management or Referrals preferred.

Essential Technical/Motor Skills
Strong knowledge of and experience with Microsoft Office applications with an intermediate level skill level with MS Excel. Basic knowledge of database management. Capable of high volume, accurate data entry. Knowledge of general office procedures and use of standard office equipment. Attentive to detail, responsible, takes initiative and multi-task oriented. Possesses excellent verbal and written communication skills. Maintains effective, positive working relationships with coworkers and management. Bilingual preferred.

Interpersonal Skills
Caring attitude, highly flexible, team player. Strong interpersonal and communication skills and the ability to work effectively with management, clinical staff, providers, and other staff members to achieve appropriate outcomes. Ability to work in a fast-paced environment under stressful situations. Must be well organized.

Essential Physical Requirements
o Work is normally performed in a typical interior/office work environment. Essential physical requirements of this job include repetitive motions of wrists, hands, and/or fingers. Moderate to frequent: standing, walking, lifting/moving items up to 20 pounds, using proper lifting techniques and using assistance as needed, reaching, kneeling, bending, stooping, pushing, and pulling.. Ability to read forms, computer screens, correspondence and other documents. Must have flexible schedule, able to work evenings and Saturdays if needed.

Essential Mental Abilities
Ability to exercise independent judgment within their scope of practice; knowledge of departmental and HIPAA policies and procedures, standards and regulations, ability to follow Joint Commission standards, state and federal regulations; ability to read, comprehend, and analyze documents, regulations and policies; ability to prepare and submit complete documents necessary to the job concisely, accurately and timely. Must be able to pay attention to detail, manipulate/ interpret numbers, perform calculations, advanced assessing/evaluating, problem-solving/reasoning.

Essential Sensory Requirements
Essential sensory requirements include the ability to: read computer keyboard, monitor, and documents; prepare and analyze documents; read extensively; receive and convey detailed information orally, by telephone and in person; convey accurate and detailed instructions by speaking to others in person and by telephone.

Exposure to Hazards 
Worker is subject to inside environmental conditions on a frequent basis with moderate/extreme noise. Possible exposure to toxic materials, communicable diseases, body fluids/blood, and exposure to or use of sharps.

Blood/Fluid Exposure Risk

Category III - Tasks involve no greater exposure to blood, body fluids or tissues than would be encountered by a visitor.

Age Specific Competency
Position does not involve patient care. Position will demonstrate general knowledge and skill to effectively communicate and provide safety measures to all life cycles.

Telecommuting:
Position eligible for partial Telecommuting

Benefits

*Coverage below based on a 1.0 FTE; Medical, Dental, Paid Leave, Holidays are prorated based on FTE

Salary : $150 - $200,000