What are the responsibilities and job description for the Referral Coordinator position at Pcc Community Wellness Center?
Job Purpose: Responsible for coordinating care for specific populations of patients primarily at home site. Ensures referrals generated by PCC are completed by addressing barriers to care, increasing patient motivation, and establishing professional, dynamic relationships with patients, providers, referral sources, and other involved parties
Essential Duties and Responsibilities:
Provides excellent customer service to internal and external customers
Engages patients as active participants in their care
Assists patients in scheduling and completing referrals as needed by coordinating between the patient, provider(s), and the referral source
o Establish relationships to coordinate patient referrals between patients provider and referral source to promote patient-centered services and ensure all reports are received by PCC
o Completes all appropriate authorization forms/steps needed by different payers & administrators Must be proficient with online requests for authorizations for different payers as needed.
o Reviews patient financial information to determine patients financial class (All Kids, Medical Presumptive Eligibility (MPE), SFS, HMO, POS, Commercial, etc.) Ensures complete and accurate information is in patients record, including demographics and current insurance information.
o Reviews details and expectations regarding authorizations with patients. Serves as point person for patients and families for any questions or concerns they may have regarding their referrals to outside specialists, testing, etc.
o Assists patients in problem solving potential issues related to health care system, financial or social barriers (e.g. request interpreters as appropriate, transportation services or prescription assistance).
Directs all reports to primary care provider.
Notifies primary care provider of any incomplete/unsuccessful referrals
Answer phone calls from patients and other departments, and communicate with referral sources
Maintain ongoing tracking and documentation on referrals, and ensure complete and accurate patient registration
Regularly attend and participate in monthly site team meetings
Follow guidelines to enhance care coordination for high-need, high-risk patients, tracking of high-risk areas as needed
Develop supportive services and tools to address common barriers to care for PCC patients; integrate these with other initiatives for health promotion/education and access to care
Work on-site at a PCC clinic at least 3 days per week and travel between PCC sites as needed.
Performs other duties as required and assigned
Basic Qualifications:
Experience/Training: High school diploma required. Medical Assistant diploma from an accredited Medical Assistant program preferred. Certified or Registered Medical Assistant preferred. Associate or bachelors degree preferred. Previous healthcare experience preferred Proficient in MS Office Business Application to include: Outlook, Word, PowerPoint and Excel
Physical Demands:
Must be able to remain in a stationary position 50% of the time. Must be able to move around the clinic site 50% of the time. Constantly operates a computer, computer printer, copy machine, and telephone. Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another. Must be able to transport from one site to another. Must be able to cover other shifts as necessary. Required shift rotation.
Other Skills:
Ability to read and write proficiently using the English language.
Constantly communicates with other healthcare providers. Must be able to exchange accurate information in these situations.
Follow-through, assume responsibility and use good judgment.
Maintain professionalism under stressful situations.
Self-motivated and directed with the ability to prioritize and work efficiently under pressure.
Ability to understand and follow verbal and written communication.
Detail oriented with the ability to work with minimal/no supervision.
Willingness to be part of a team-unit and cooperate in the accomplishment of departmental goals and objectives.
Effective and creative problem solving.
