Referral/Medical Records Specialist - Portland, United States - Orchid Health

Description

Job Description

Seeking a Referral/Medical Records Specialist to Join Our Team

Great Work Environment and Pay

Position Description:

The Referral/Medical Records Specialist is one of the most important roles at Orchid Health. The Referral/Medical Records Specialist receives and documents patient referrals and follows Orchid Health's referral/medical records process. Working with the patient/family, primary physician, Medical Director, and Clinic Healthcare Team, the Referral/Medical Records Specialist coordinates all patient referrals at the request of the providers, obtain/review pre-authorization/pre-certification, and coordinate communications with physician offices, companies, third-party payers and case managers; documenting appropriately within the medical record.

Responsibilities:

• Ensure appropriate appointments and follow-up appointments in the clinic following referral requests/visits.
• Ensure documentation from specialists/offices is obtained, filed in the chart and forwarded to companies/payers as appropriate.
• Appropriately and accurately pulls records for patient care, quality reviews and audits in a timely manner.
• Perform patient registration tasks and procedures as requested as well as assist in the clinical area as trained and requested.
• Initiate all referral requests within 24-48 hours on business days.
• Return all calls promptly generally within the same day.
• Document all stages of the referral process within the EMR program (Athena) and communicate to the appropriate people regarding injury cases.
• Coordinate and schedule specialty exams within the clinic as necessary.
• Obtain and/or document approvals from Third-Party Payers for payment for services as directed or indicated via protocols.
• Answer phone calls and act as a liaison between companies, patients, attorneys and work comp insurance companies.
• Request any missing documentation from providers, once received and signed off by the medical director, scan appropriate information into the EMR program (Athena).
• Resolves pre-certification, registration and case-related concerns prior to a patient's appointment.
• Gather pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided.
• Use the EHR (Athena) to monitor referral orders and document all referral activities in the EHR.
• Complete prior authorizations when needed.
• Complete appropriate referral forms.
• Consult with providers regarding specific diagnosis information, as it relates to the referral.
• Comply with federal, state and local regulations regarding patient confidentiality and HIPAA.
• Ensure that patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. Perform other job-related duties, as may be assigned

Must Haves:

• High school diploma or GED certificate.
• Minimum of 1 year relevant healthcare experience
• Proficient at Excel, Word, and Outlook.
• Excellent communication and problem-solving skills.
• Excellent interpersonal skills, empathy and tact, when dealing with insurance companies, patients and other health care facilities.
• Able to assume the responsibilities delegated by the Manager, to provide efficient and effective coordination of care.
• Willing to adapt to changing situations and circumstances.

Nice to Haves:

• Bilingual in Spanish.
• Athena experience.
• Knowledge of medical terminology
• Work Environment
• This job operates in a professional medical office environment. This role routinely uses standard office equipment. Such as computers, phones, photocopiers, filing cabinets and fax machines.

Compensation

• $ $22.00/ hour depending on experience, and skills

Benefits:

• Medical /Dental/Vision / Orchid pays 100% employee and 50% dependent monthly premiums for base medical and dental plans.
• Yearly $1000 Employee Wellness Benefit.
• 100% vested 401k with Orchid match after 1 year.
• All employees have a Continuing Education / Continuing Medical Education budget.
• 120 hours of PTO per year, annually front loaded.
• 8 paid holidays plus your Birthday.
• And more

*Benefit eligibility first of the month following 30 days of employment

Physical Demands

The physical demands described here are representative of those that must be met by an employee successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk and hear. The employee is Frequently required to sit for extended periods of time.

AAP/EEO Statement

It is the policy of Orchid Health to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Orchid Health will provide reasonable accommodations for qualified individuals with disabilities.

Employment Offer Contingencies

Job Offer is contingent upon the successful completion of a background check, as well as a successful completion of a drug screening.

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