Referral Clerk - Twentynine Palms, United States - AAI

AAI

Verified Company

Twentynine Palms, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

REFERRAL CLERK
Twenty-Nine Palms

AAI is actively looking for a referral Clerk.

This position provides clerical/administrative support in the Referral Management Center for customer service, referral tracking, referral appointing, and reporting activities.

This position will support the daily functions of specialty care referral appointing, referral review and coordination, beneficiary counseling and referral tracking at the MTF.

RESPONSIBILITIES:

A fully qualified typist with a minimum of 50 WPM is required.
Demonstrate general medical ethics, telephone etiquette, and excellent communication and customer service skills.
Possess general office administrative and clerical skills to perform receptionist duties and answer telephones.
Ability to communicate effectively, both orally and in writing.
Work Environment/Physical Requirements. The work is primarily sedentary. However, there may be some physical demands. Requirements include prolonged walking, standing, sitting or bending.

REQUIREMENTS:

High school diploma or General Educational Development (GED) equivalency. Completion of an Administrative Assistant program is desired.
At least 6 months of experience in medical office setting.
Possess and maintain current certification in American Heart Association Basic Life Support (BLS) for Healthcare Providers. Training shall be the responsibility of the contractor and is at no cost to the Government. Contract workers not currently in possession of current certification must acquire certification prior to initiating contract performance. Web based classes do not meet these standards. Certification Card must display the American Heart Association or Military Training Network Emblem.

UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:

The MHS GENESIS or other MTF ICD-B programs must be utilized for referral management services. Access will be granted by local MTF connectivity and the contractor shall comply with MHS communications and Government IT security standards and policies. The military facility will provide system accounts for MSS personnel after required training and security procedures have been completed by the contractor. If the Military Health Service processes moves away from specified systems, the government will modify the task order

PERFORMANCE OUTCOMES:

Note:

All specialty care and Right of First Refusal (ROFR) referrals/consults shall be managed per current DHA and MTF referral management policies and guidance.

All specialty care referrals will be appointed to the MTF/Direct Care System within prescribed Access to Care (ATC) Standards or referred to the local network.

Greets patients/visitors at a front desk, referral center or office setting.
Answers main office phone line(s). Directs telephone calls to appropriate section for assistance, handles independently or takes messages as required.
Reviews all incoming CLR referrals for administrative accuracy, completeness, and legibility, and posting of consultation reports for patients referred both to and from providers
Determines patient eligibility for services, arranges and schedules medical appointments for referred care, and contact the physician's office, if an incoming report does not meet the CLR standards.
Provides general instructions to patients and ensures patients have necessary documentation for referred health care services.
Obtains updates and files medical records as needed.
Organizes and researches patient records, extract needed information, and review records for referral results within established guidelines.
Request medical records and ensures arrival of medical records prior to appointment(s).
Initiates and locates patient medical records as needed. The contractor shall establish and maintain suspense files for referrals deferred to the network and compile and maintain data for reporting and tracking purposes.
Obtains documentation as requested by healthcare providers (test results, or documentation not yet filed in records), and provide CLR receipts validation and shall crosscheck referral authorizations against claims adjudicated.
Ensures referral results are returned to the referring provide and to the medical record within required timelines. Assists with follow up, written or verbal, as necessary. Notifies MTF providers when a CLR is posted and monitor timelines of incoming CLRs.
Utilizes the referral tracking data collection tool. Calculates metrics and compiles monthly statistic reports which includes the number of actions processed each month. It is estimated that approximately 20,604 administrative referral transactions will occur during a twelve (12) month period; to include telephone consults (Tcons) into MHS Genesis. The workload may increase depending on availability of specialists or specialty support

services at the MTF and unexpected influx in the number of beneficiaries to the area.