Referral Coordinator

We offer exceptional benefits that exceed those of our competitors!

We are an equal opportunity employer. All qualified applicants will receive consideration for employment. We do not discriminate for any reason. We welcome talented individuals who believe in our mission, drive the organization forward, and recognize the positive impact they can bring to our communities.

Job Title: Referral Coordinator

FLSA Status: Non-exempt

Bilingual (English & Spanish) Required

Grade: N/A

Department: Operations

Title of Supervisor: Manager, Referrals

Date: June 2023

Position Summary

The Referrals Coordinator is responsible for working within the Epic system and insurance portals to process all ACCESS referrals that are generated by the clinical providers, to ensure that the patient is being referred to the appropriate in-network provider, and that the services are approved as stipulated by the patient’s current benefit plan requirements.

Core Job Responsibilities

• Work with Payors/Plans to process referrals/authorizations to completion according to policy and procedure.
• Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services.
• Assist patients with questions regarding referrals.
• Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s).
• Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure.
• Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; acts as a resource to answer questions and solve problems
• Maintain accurate information regarding what services require prior authorization for each Payor/Plan.
• Maintain accurate information regarding which external providers are contracted with each Payor/Plan.
• Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling.
• Monitor referral phases to maintain compliance
• Monitor referral dashboards and work queues daily
• Perform other duties as assigned.
  
  

Requirements/Preferences

• High school diploma or GED required
• Minimum 1-year experience in a clinical office or health care environment in patient registration, referrals, medical assisting or customer service required.
• 1-year EHR Systems experience, preferred, EPIC a plus
• Bilingual/Spanish preferred
• Beginning proficiency Microsoft Office Suite (Word, Excel, Outlook)
  
  

Competencies/Behaviors

• Strong customer service orientation
• Communication - strong written, oral, and presentation skills; share information that aligns with audience needs (especially via phone)
• Organization – organize and prioritize duties and responsibilities; effective multi-tasking, detail oriented, accurate
• Interpersonal skills –interact with patients and staff in a friendly and respectful manner; approachable
• Problem Solving - identify/define problems; gather data, establish facts, and draw valid conclusions escalate issue to manager when appropriate
• Collaborative; work within a team
• Flexibility/adaptability - flexibility on the job, readily respond to changing circumstances, expectations and changing work demands
• Emotional Intelligence - exhibits confidence, empathy and respect when communicating with customers (patients), leadership and staff
• Cultural competency – experience and ability to work in a multi-cultural environment; shows respect and openness towards individuals whose social and cultural background is different from one’s own.
  
  

Working Conditions/Equipment

• Health Center environment
• Ability to sit for up to 4 hours at a time
• Computer/laptop
• Phone/Fax/Copier/Scanner
  
  

ACCESS is a Network of Federally Qualified Health Centers treating patients on the frontlines of community-based health care. Depending on position applied/being recruited for , candidates may be required to be vaccinated against communicable diseases , and provide supporting documentation proving that they are properly vaccinated, or apply for religious and/or medical vaccination exemption as a part of the application process.

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