Referral Management Coordinator
Department: Union Square
Job Type: Full Time
Job Class: Union
Union Name: SHLABOR -Laborers Local 381
Work Shift: Day/Evening with Variable Start Time
Work Days: M-F with rotating hours including evenings, holiday and Satu
Date Posted: 01/21/2019
Requisition Number: hrq-86039
The Referral Management Coordinator will provide on-site, pro-active management of referrals at CHA Union Square Family Health. The Referral Coordinator provides excellent customer service to patients and assists in achieving appropriate care at the most convenient time.
Job - Specific Duties and Responsibilities: 1. Collect demographic and pertinent information. Enter information into department's computer application programs such as Epic. 2. Verify eligibility and insurance information for all new, repeat and pending referrals. Acquire referral authorization numbers. 3. Enter authorization numbers into referral authorization systems 4. Communicate assigned referral information and/or necessary decision data to providers. 5. File all documents in patient's medical record according to the established format. 6. Run daily/weekly Referral Management reports. 7. Assist in the collection of referral utilization data. 8. Work directly with patients via the telephone to confirm and resolve issues regarding the primary care physician's referral. Add patients to CHA primary care provider panels as necessary. 9. Fax and track all referrals and certificates of medical necessity. 10. Confirm and book specialty/ambulatory appointments. 11. Assist with the implementation of all new referral management processes and programs in accordance with CHA business initiatives of providing quality customer service to all customers. 12. The Referral Coordinator is responsible for contacting the patient and resolving discrepancies. 13. Work closely with CHA Specialty Care Offices and Central Referral Office to coordinate and manage internal and external referrals. 14. Accountable for measurement targets (to be determined). Perform all job functions in compliance with all Federal, State, Local and CHA policies or procedures. 15. Assist with front desk duties/coverage as needed. 16. Attend departmental meetings as assigned.
Education/Training: Associates Degree or Bachelor's degree preferred
Work Experience: A minimum of 2 years administrative experience, preferably in a medical setting. Experience in processing referrals.
Skills: Must be an effective team player with strong communication inter-personal skills. Must have demonstrated ability to maintain dynamic and responsive interactions with patients, insurers and medical professionals. Demonstrated ability to work and make decisions in a fast paced environment. Proficient in Microsoft Office and other windows-based computer application programs. Bilingual in Portuguese preferred.