Referral Coordinator - Oakland, United States - Native American Health Center Inc

Description

***The Referral Coordinator (RC) is key member of the Medical department and is responsible for managing patients' medical referrals to specialists, ancillary services,and to other NAHC departments. The RC will track all referrals in patients' electronichealth records, work closely and proactively with the clinical care pods (i.e., providers,MA's, RN's, Care Coordinators) to ensure patients' referrals are effectively managedfrom start to finish, and that information is updated and available in the electronic healthrecord (EHR) system. This position requires a high level of customer service.

The Native American Health Center is an accredited institution and adheres to thestandards of excellence set forth by the Accreditation Association of Ambulatory HealthCare (AAAHC) and the Commission of Dental Accreditation (CODA).

DUTIES AND RESPONSIBILITIES

Referral Coordination

• Manage and coordinate all referrals generated in the Medical department fromstart to finish. This will include sending referrals to specialists, ensuring their

receipt, informing patients of referrals, and following up to see such appointmentswere kept.

• Responsible for verifying eligibility and benefits through insurance companies. including prior authorization request.
• Responsible for coordinating and processing prior authorizations for eachassigned referral.
• Proactively work with Medical Assistants to ensure follow up on patients'specialty appointments.
• Schedule specialty appointments for patients; notify and remind patients of suchappointments by phone and by letters through the United States Postal Service.
• Provide patient education on specialty appointments and address all patientquestions in a manner that ensures their understanding.
• Refer patients to NAHC's Eligibility Specialist as needed to help ensure coverageof care as related to specialists and the insurance they accept.
• Maintain a tracking system for referred appointments that includes referred date,dates and times of referral appointments, missed appointments, and the recallprocedure.
• Document all telephone calls and letters in the EHR.
• Develop and cultivate positive working relationships with specialist providers.
• Document referral workflows and support Site Director in developing and editingon-boarding materials for incoming staff as related to referral flow and

management, as necessary.

• Train incoming staff on referral processes, as needed. This may include one-timetrainings, or on-going trainings and on-boarding.
• Proactively work with RN Clinic Manager, Lead Physician and Site Director toresolve any technical or flow issues regarding referrals.

General Duties

• Attend internal and external meetings as requested by supervisor.

Employee Safety:
Safely performs all duties; follows required protective protocolsto ensure personal safety as well the safety of others.

• Must maintain compliance with ergonomic safety standards; be mindful ofposture and regularly practice ergonomic stretches.

Quality Improvement:

Actively participate in internal quality improvement teamsand work with members proactively to drive quality improvement initiatives inaccordance with the mission and strategic goals of the organization, federal andstate laws and regulations, and accreditation standards, when assigned.

• HIPAA: Keep all protected health information (PHI) confidential and abide byHIPAA policies for the release and disclosure of any PHI. Will report unauthorized use of disclosure of PHI immediately, to supervisor or HIPAAsecurity officer.
• Work well under pressure, meet multiple and often competing deadlines.
• At all times demonstrate cooperative behavior with supervisors, subordinates,colleagues, clients and the community.
• Other duties as assigned by Supervisor.

MINIMUM QUALIFICATIONS

• Must have high school diploma or equivalent.
• One year of work experience in a health care setting.

Vaccination Level 1:
Must be able to provide TB, Physical, seasonal fluand proof of Vaccination immunity for Measles, Mumps, Rubella,
Varicella, TDAP & Hepatitis B, prior to start date. If vaccination recordsare more than 10 years old, titers are required to confirm immunity.

• BLS/CPR certification must be obtained prior to start date and keptcurrent at all times.
• Computer literate and have experience with Microsoft Office suite (Word, Excel,Outlook), and be savvy in Excel.
• Knowledge of medical terminology.
• Sufficient skill in typing; have the ability to type a minimum of 25-30wpm.
• Must be well organized; set priorities appropriately; and work extremely wellindependently as well as within a team.
• Possess excellent customer services skills and interact with the public in acourteous, professional and tactful at all times.
• Excellent communication skills, both verbal and written; must have the ability tocommunicate effectively with multiple audiences.
• Must be able to exercise independen