Referral Coordinator, Full Time, Days, Cobleskill Health Center

The best thing about this role

Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible.

What you'll do

The Referral Coordinator coordinates the referral process for patients in the regional health centers from scheduling to receipt of visit completion. The primary objective of the position is to accomplish accurate, timely, and through centered care team. They act as an effective liaison between primary care physicians, specialty physicians and patients. Review and verify insurances that require pre-authorizations and monitor timeline for specialty care. Keep referring providers informed of patient compliance, statistics of referral patterns. Demonstrates a high level of understanding or acts as a subject matter expert for certain facets of the job. Takes a lead in the training of new, incoming staff members.

• Demonstrates an understanding of the elements of the referral process/program

• Performs referral coordination including completing Open Referrals and/or referral tracking queue

• Work the (scheduled and unscheduled) queue in your area according to department standards

• Follow-up with “referred to” providers to ensure that patients kept their appointments and all results have been received in the “referral by” providers office

• Verify out of network referrals

• Processes electronic or written requests for urgent referrals same day. Processes electronic or written routine referral requests within 24-72 hours

• Communicate to patients out of network insurance deductibles and “co-insurance.”

• Acquires medical necessity documentation

• Obtains prior approval or prior authorization as required by the patient’s insurance

• Obtains all information necessary to complete the referral process ensuring demographic and insurance information is correct and is entered or scanned in the system accurately, as monitored by system audit

• Communicates referral appointment instructions to the patient

• Communicates with clinicians to bring referral/insurance/prior authorization updates

• Acts as a liaison with external provider offices

• Acts as a subject matter expert in referral coordination functions

• Takes a lead in the training of new incoming staff members

• Meet with all new clinicians to orient them to their role in the referral process

• Alerts management of referrals that are unable to be completed due to missing information that could lead to compliance or safety issues

• Communicates to the ordering clinician if patient does not schedule, does not attend, or any circumstance that the patient does not follow-though on the ordered referral. Takes appropriate follow-up action, as directed by the clinician

• Registration/Scheduling Appointments

• Ensure accurate data capture necessary for regulatory agencies and compliance requirements is accurate and complete as monitored by systems audits

• Maintains required level of knowledge and proficiency in all core functions (demographic and financial screening, insurance eligibility and verification, regulatory and compliance monitoring) of front desk services as measured by system audits

• Ensures all corrections (demographics, insurance eligibility, etc) are made in the appropriate Bassett system within 24 hours of system notifications in accordance with standard operating procedure

• Answers questions from patients regarding the organization and/or services and provides directions to the appropriate clinical location as necessary

• Listens to patient’s request for appointment, then schedules an outpatient appointment to meet with patient’s needs while following department scheduling guidelines as reported by providers and observed by supervisor. Offers alternate providers or locations when appropriate to meet the patient’s needs. Raises up patient needs that cannot be meet by the referring provider

• Ensures complete and accurate information is recorded in accordance with standard operations procedure and Healthstream module to support reimbursement and regulatory compliance and patient care

• Displays ownership of the entire patient experience, including but not limited to, scheduling, registration, being aware of the patient’s experience, and completion of all referral duties

• Under direction of supervisor, runs daily operational reports, and processes those reports, encouraging teamwork for completion as monitored by leadership

• Answers and/or is available for incoming calls from patients, insurance companies, and medical offices

• Takes clear, complete and accurate phone messages, and follows up on these messages to make sure the patient’s needs are met

• Office Support/Cross Coverage/Confidentiality

• Date stamps all incoming patient related information and delivers to appropriate provider or staff person for action on a daily basis as observed by providers, coworkers and supervisor

• Completes all basic patient demographic information on forms

• Mails outgoing patient information such as completed forms, directions, referral letters, forms within 24 hours of completion

• Prepares correspondence to patients and/or other entities as directed by providers or supervisors as observed by providers and supervisors

• Prepares outside patient health information for scanning per Document Imaging procedures as observed by certified document imaging staff or Supervisor

• Maintain appropriate inventory of office supplies and required forms for daily operations following established procedures

• Ability to adapt to various workflows, processes and policies to support the operations and patient care throughout the network

• Communicates patient issues/concerns to providers as measured by provider feedback and supervisory observation

• Ensures appropriate forms are given to all patients depending on appointment type and or specialty

• Assists the patient to navigate through all stages of their referral

• Assumes responsibility for continuing education by maintaining competency in programs required for daily responsibilities and insurance issues

• Attends required in-services as requested by supervisor

• Identifies need for computer training or refresher courses and attends as necessary

• Attends 85-90% of all staff meetings, reviewing minutes of any meetings missed with no more than 1 exception per year as measured by supervisory audit

• Maintains job specific knowledge and proficiency (may include FSC, scheduling, chart coding information and creation of open referrals) by attending meetings, training and reading all pertinent training documentation and memos as documented on annual in-service record

• Maintains a thorough knowledge and understanding of Bassett financial classes/payers and local carrier’s medical coverage policies as they relate to the referral process

• Performs similar or related duties as requested or directed

What we need from you

Education:

• High School or GED, required

• 2 Year/Associate Degree, preferred

Experience:

• Minimum 2 years office experience, required

• Medical office/billing experience, preferred

Skills:

• Accountability

• Attention to Detail

• Communication

• Customer Service

• Facilitate

Physical Requirements:

• Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met

• Occasional balancing, climbing, crouching, grasping, kneeling, lifting, pulling, pushing, reaching, standing, stooping, and walking.

• Frequent typing/clerical/dexterity, hearing, repetitive motion, seeing/monitor/computer use, talking, and visual acuity (color, depth, perception)

Travel:

• Occasional Travel - The job may require travel from time-to-time, but not on a regular basis

Total Rewards

Bassett Healthcare Network’s commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett. Our generous benefits offerings include:

• Paid time off, including company holidays, vacation, and sick time

• Medical, dental and vision insurance

• Life insurance and disability protection

• Retirement benefits including an employer match

• And more!

Specific benefit offerings may vary by location and/or position.

Pay Range

Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.

Pay Range Minimum:

USD $18.38/Hr.

Pay Range Maximum:

USD $27.57/Hr.

We love the difference people bring

We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.