Referral Coordinator Part Time (Bilingual English-Spanish Required)

Job Title: Referral Coordinator (Part Time)

Reports To: Medical Records Supervisor

FLSA Status: Non-Exempt

Bilingual English - Spanish Required

Starting @ $19.15/hr

Summary:

The Referral Coordinator is responsible for receiving, processing, scheduling, and following up on all medical referral requests from assigned care team providers. This includes all in-house and outside referrals for diagnostic testing, medical specialists, or other providers.

Essential Duties and Responsibilities

• Receives and reviews all referral requests/orders from care team providers to initiate referral tracking protocol.
• Maintains ongoing tracking and appropriate EHR documentation to promote team awareness and patient safety for all in-house and community service provider’s referrals.
• Completes forms for Medicare, Department of Health, Social Services, Insurance, and specialty offices. Faxes referral forms/order sheets with visit notes and other necessary information to specialist or other medical service providers.
• Screens managed care referrals for potential pre-existing conditions and/or requests for out-of-contract benefits. Follows guidelines to request a waiver of pre-existing condition, or to cover out-of-contract service for preauthorization requirements; obtains authorization information when necessary.
• Obtains insurance authorization for appointment if necessary.
• Contacts patients prior to scheduling appointment to assess patients scheduling preferences/needs and potential need for social work involvement. Reviews details and expectations about the referral with the patient.
• Assists patients with problem solving potential issues related to healthcare system, by communicating with internal departments to find resources if available.
• Contacts patients to provide appointment date, time, location, and preparation information if appropriate.
• Communicates approval or denial of referral authorization through EMR referral system to provider/care team. Communicates approval of referral authorization by specialist as appropriate.
• Answers questions regarding patient appointments and testing. Facilitates any testing/lab work needed prior to the referral appointment.
• Answers telephone, screens calls, takes messages and provides information concerning the referral process.
• Follows up on incomplete referrals (patient no show/cancel appointment) as per policy.
• Assure records are received and routed to provider for review for all referrals.

MARGINAL DUTIES

• Participates in in-service education programs, functional team meetings and care team/department meetings.
• Participates in quality improvement, as appropriate.
• Performs any other duties as may be necessary for the efficient and effective operation of the clinic and care of patients or as assigned by the supervisor or his/her designee.

PERFORMANCE CRITERIA

• Patient’s needs are handled in a timely fashion with any delays promptly communicated to the patient and ordering provider.
• Responsibilities are performed in a competent manner, within scope of practice and with minimal supervision. Information provided to providers, staff, and community providers is clear, accurate and timely.
• All referrals are addressed in a timely manner as defined in current protocols and policy.
• Referral data is entered into EMR/referral tracking system in an accurate manner and abides by required data entry timelines.
• Is responsive to phone calls and messages from providers, referral agencies and patients concerning the referral process to establish, promote and maintain positive relationships with identified service providers and patients.
• Prior Authorization and faxes as assigned.
• Adheres to current employee dress code, appearance is neat, clean, and professional.
• Works effectively with all care team members, supervisors, and others to continuously improve the operation of the clinic for the welfare of our patients and to build and enhance teamwork and respect throughout the clinic.
• Is customer-focused and professional toward patients. Displays a professional and courteous telephone manner at all times.
• Accurately documents in/out time and PTO requests using Family Healthcare’s time and attendance system.
• Adheres to all safety protocols.
• Maintains confidentiality and compliance with HIPAA policies at all times.
• Documentation is clear, concise, accurate, and completed at the time of the encounter.
• Supplies are adequately maintained at all times.

SUPERVISION AND EVALUATION

Supervised and evaluated by the Medical Records Supervisor with input from the operations team COO and CEO.

Qualifications - Education/Experience:

• High school diploma or GED equivalent.
• Medical records experience preferred.
• Bilingual in English and Spanish preferred.
• Basic familiarity with medical routine and terminology.
• Great communication skills.
• Attention to detail.
• Ability to work well as a team, exhibit integrity, use good judgment and keep confidential information.
• Demonstrate reliable attendance and punctuality.
• Electronic health record experience preferred.
• HIPAA knowledge and experience preferred.
• Minimum one year experience in the medical field with knowledge of medical terminology and abbreviations and understanding of patient flow processes.
• Ability to appropriately communicate/deal with irritated or frustrated patients; to work under stressful conditions.
• Knowledge of and ability to apply established professional customer service concepts, principals, and practices.
• Ability to prioritize and execute a variety of tasks simultaneously.
• Ability to work with frequent interruptions.
• Proficient computer skills.
• Keen organizational skills.
• Ability to read, write and communicate clearly in English and Spanish.

PREFERRED QUALIFICATIONS

• One or more years in a medical community health clinic setting.
• Previous referral coordination experience in an outpatient setting.
• Electronic medical record experience