Referrals Supervisor

Description

Neighborhood Outreach Access to Health (NOAH) is a non-profit Federally Qualified Health Center (FQHC) that provides comprehensive, integrated, and affordable high-quality healthcare services to underserved populations. We provide comprehensive care to over 40,000 neighbors including medical, dental, behavioral health, psychiatric, nutrition, pharmacy services, preventive health, eligibility assistance, and health education programs. NOAH embraces all people, and we respect everyone for who they are. We firmly believe that diversity is our strength and stand firmly committed to the principles of Justice, Equity, Diversity, and Inclusion.

Job Summary:

The Referrals Supervisor trains and directs staff in specialty referrals, eligibility verification, and patient record maintenance.

Supervisory Responsibilities:

• Participates in interviewing, selecting, hiring, and onboarding staff.

• Oversees the day-to-day operations and work assignments of staff.

• Provides training, advice, and direction for staff.

• Delivers regular performance feedback and constructive performance evaluations; follows established disciplinary and termination procedures as needed.

• Ensures staff adhere to and follow all organizational policies, safety standards, and healthcare regulations.

Duties/Responsibilities:

• Develops and implements program workflows, policies, and procedures.

• Oversees referral processing and approves specialist referrals according to established criteria and guidelines.

• Ensures accurate and timely processing of referrals and prior authorizations in accordance with accepted standards, guidelines, organizational policy, and regulatory requirements.

• Resolves issues and complaints between practice, patients, referral sources, and health insurance companies.

• Maintains knowledge of all facets of referrals and eligibility verifications; serves as a subject matter expert to staff.

• Develops and updates NOAH’s Referral Training Program.

• Monitors network leakage, identifies trends, and recommends corrective actions and/or process improvements.

• Ensures compliance with HIPAA requirements and other laws and regulations.

• Conducts data entry, audit, and transmission duties, including entering and reviewing non-clinical information in EMR, compiling, and verifying information from multiple sources, importing pertinent medical data and documentation into appropriate database, and submitting relevant data to appropriate receiver.

• Verifies eligibility, benefits, and contractual appropriateness.

• Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.

• Performs other related duties as assigned.

Qualifications

Required Skills/Knowledge/Abilities: 

• Strong management skills and ability to train.

• Excellent verbal and written communication skills and ability to interact with individuals of various social, cultural, and educational backgrounds.

• Good organizational skills and administrative abilities.

• Knowledge of medical terminology.

• Excellent problem-solving and critical thinking skills.

• Detail-oriented and professional.

• Ability to exercise confidentiality, discretion, and good judgment.

• Proficient with Microsoft Office Suite and EMR software.

Education and Experience:

Required:

• Associate's degree or equivalent work experience.

• 3 years of referral processing, including pre-authorizations.

Preferred:

• 2 years of customer service experience; healthcare industry experience.

Other Requirements:

• New Hires are required to pass pre-employment background check and drug testing (effective 11/1/2022).