Referral Management Coordinator - Worker's

Referral Management Coordinator - Worker's Compensation

Location: US-TX-Plano

Job : 352587

Recruiter: Cecilia Dunn

Position Type: Full Time

Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.

Do you want to use your problem solving skills and knowledge of customer service to help improve the health of America's workforce? At Concentra, we serve more than 500 medical centers and 130 onsite clinics nationwide. Concentra colleagues remain fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner.

We do this by putting all customers first.

The Referral Management Coordinator maintains high standards for quality and an exceptional patient experience in accordance with Concentra's policies, procedures and applicable regulations. The Referral Management Coordinator processes referrals requests and authorizations while working closely with physicians, employers and payors. Customer services is a top priority in order to achieve a positive impact on the cost and quality of care rendered to injured employees.

• First point of escalation for all case related issues requiring guidance
• Responsible for daily completion of assigned patient referrals, while meeting production requirements
• Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market
• Obtains authorization for Specialist referrals and schedules appointments accordingly
• Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable
• Provides all necessary information such as medical records, prescriptions, etc. to payor
• Communicates with stakeholders, payor, employer, and patient as appropriate
• Records all appropriate information via OA/CR module of Occu Source per Concentra policy
• Builds relationships with provider, employer and payor communities
• Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor
• Handles calls according to the call guidelines of the department
• Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions
• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

• Must be a current Texas Resident
• Must remain a Texas Resident during the duration of employment within the Referral Department
• Must be able and willing to travel to a local Concentra to complete new hire orientation

• Education/Credentials:
  • High school diploma or GED equivalent
  • Associated Degree from an accredited college preferred
• Physical Requirements:
  • Must be a current Texas Resident
  • Must remain a Texas Resident during the duration of employment within the Referral Department
  • Must be able and willing to travel to a local Concentra to complete new hire orientation
• Job-Related
  
  Experience:
  
  
  • Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)
  • Experience with Worker's Compensation preferred
  • Proficiency with scheduling/insurance verification software
• Job-Related Skills/
  
  Competencies:
  
  
  • Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
  • The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
  • Familiarity with Microsoft Excel, Outlook, Word
  • Excellent communication skills and ability to communicate (both written and orally) effectively with colleagues at all levels of the organization
  • Must display proper business etiquette and be skilled in the arts of diplomacy and tact
  • Excellent time management skills including the…