Referral Coordinator for Concierge Medicine - Las Vegas - Strategic Systems

    Strategic Systems
    Strategic Systems Las Vegas

    4 days ago

    Description
    Job Title: Referral Coordinator for Concierge Medicine
    Reports To: Manager of Concierge Medicine
    Work Location: On-site
    Status: Exempt
    Full Time/Part Time: Full-time

    Job Description:

    You will be expected to ensure:
    • All external results are received, documented, and acted upon.
    • Pre-authorizations and insurance requirements are met proactively.
    • Patients are not lost in transition between providers or systems.
    • Insurance Verification & Authorizations:
    • Confirms patient insurance coverage and obtaining necessary pre-authorizations needed from referring physicians for appointments or procedures.
  • Appointment Scheduling:
  • Coordinates appointments between patients and healthcare providers, both within the facility (Lou Ruvo) for limited services and with external specialists.
  • Patient Communication & Navigation:
  • Serves as a primary point of referral contact for patients, answering questions, providing information, and guiding them through the referral process.
  • Provider Coordination:
  • Coordinates with primary care physicians, specialist providers, hospitals, and other healthcare facilities to facilitate the transfer of medical information and ensure continuity of care.
  • Documentation & Record Keeping:
  • Maintains accurate and up-to-date patient records, including progress notes of referral, preparing charts before the next follow up visits, etc. in the EPIC system.
  • Compliance & Regulations:
  • Ensures all referral activities adhere to healthcare policies, insurance guidelines, and privacy regulations like HIPAA.
  • Referral Tracking:
  • Implements tracking mechanisms to monitor the status of each referral and ensure patients receive their appointments in a timely manner.
  • Chart Scrubbing:
  • Ensures patient charts are accurate and free of errors or missing information before billing claims are sent to payers or for other purposes, such as risk adjustment and care gap closure. This involves checking for inaccuracies, inconsistencies, and incomplete data in the EPIC to improve data quality and ensure accurate billing and appropriate patient care.
  • Manages the process of directing patients to specialists or other healthcare services, handling tasks such as verifying insurance, scheduling appointments, coordinating with providers, and ensuring proper documentation for seamless patient experience and compliance with healthcare regulations. Key duties include communication with patients and providers, utilizing EPIC, and maintaining strong organizational and multi-tasking skills.

    Physical Requirements:
    The physical requirements for this office role include the ability to sit or stand for extended periods, typically up to 8 hours a day, and regularly operate standard office equipment such as computers and phones. Employees should be able to lift up to 15 pounds occasionally and frequently perform tasks that require typing, writing, and document handling. Effective verbal and written communication skills are necessary, along with adequate visual and auditory abilities to read materials and participate in meetings.

    EEOC Statement:
    Strategic Systems, Inc., and its affiliates, is an Equal Opportunity Employer. We are committed to creating an inclusive environment for all employees and applicants for employment without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other legally protected characteristic. We believe diversity drives innovation and we are dedicated to fostering a workplace that respects and values the contributions of all individuals.

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