Referral Coordinator

Referral Coordinator

Referral Coordinator

Department: Nexus

Location: 1500 Expo Parkway

Reports to:  Utilization Management Director

Status: Full – Time, Regular

FLSA: Non-Exempt

Pay Range: $24.90 - $32.37/hr
EEO-1:  Service Worker

Organization Information

WellSpace Health believes that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. We see you and are here for you. To that end, we have committed ourselves to finding solutions for our community’s health and wellbeing to achieve regional health through high quality comprehensive care.

Our focus has always been to offer a full range of quality medical care, dental care, mental health and behavioral health services, and enabling services to underserved people.  We do this by placing ourselves within the communities we serve and employing outstanding healthcare professionals who are devoted to our mission.

We are a Federally Qualified Health Center (FQHC) and are accredited by the Joint Commission for Ambulatory Care and Behavioral Health. We are also certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home.

Position Summary

Under the direction of the Utilization Management Director, the referral coordinator will support the day-to-day operations of the Utilization Management department.  Support Utilization Management Nurses in processing authorizations. The referral coordinator works closely with patients, patient care takers, network providers, and others to ensure patients are scheduled for specialty services in a timely fashion.

Required Qualifications

• High School Diploma or equivalent required.
• Bachelor’s degree preferred.
• Medical authorization/billing/health insurance experience.
• Attention to detail.
• Adherence to infection control procedures, including but not limited to, standard precautions of temperature monitoring, hand washing, symptom self-monitoring, masking and social distancing.
• Assist and support the Center/Department/Program to meet standards of High Reliability.
• Must have valid driver’s license and insurable driving record.

Essential Responsibilities

• Assist patients in navigating referrals for medical services including scheduling appointments, providing reminders, and communicating appointment/referral to members.
• Use online health plan resources to verify member eligibility and member benefits.
• Communicate and disseminate applicable authorization information to members and providers.
• Verify all information required for authorizations/referrals is received.
• Follow up with providers to obtain missing information required to process authorizations.
• Participate in the WellSpace Health wide quality assurance and quality improvement program.
• Support initiative to adhere to infection control procedures including but not limited to standard universal precautions.   
• Other duties as assigned.

Benefits

Successful candidate will receive regionally competitive salary, above average health benefits at reduced costs, company paid life insurance & long-term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement.

• Paid bereavement and jury duty leave
• 11 paid holidays per year
• Paid time off
• Paid sick leave
• Flexible Spending Program
• Company paid malpractice insurance for all providers
• Professional development hours offered annually

Physical Demands and Work Environment

The work environment is characteristic of a medical clinic environment.  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands to handle, or feel.  The employee is also required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus.   The employee must also possess hearing and speech to communicate in person and over the phone.  The noise level in the work environment is usually quiet.

The employee may be in contact with individuals and families in crisis who may be ill, using substances and/or not attentive to personal health and safety for themselves or their homes. The employee may experience a number of unpleasant sensory demands associated with the client’s use of alcohol and drugs, and the lack of personal care.  The employee may also be exposed to bodily fluids (blood, urine) and hazardous chemicals.

WellSpace Health is committed to the principals of equal employment.  We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations.  It is the intent of WellSpace Health to maintain a work environment free of harassment, discrimination, or retaliation because of age, race, religious creed, color, national origin, ancestry, physical disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding and/or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by federal, state or local laws.  WellSpace Health is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WellSpace Health is an Equal Opportunity Employer

Qualifications

Salary : $25 - $32