Referral Coordinator

Overview

We’re unique. You should be, too. We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team. The Care Coordinator is a highly visible customer service and patient-focused role that works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to our members.

• Coordinates and processes patient referrals to completion with precision, detail and accuracy.
• Definition of completion includes prioritizing HPP patients in Primary Care Physicians panel, ensuring orders are approved when needed, scheduling patients (Preferred Providers List of Specialist) and notifying them of appointment information (date, time, location, etc.).
• Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
• Completes orders with proper documentation on where the patient is scheduled and how the patient was notified.
• Ensures referrals have been sent to the specialist office and confirmed receipt.
• Prepares and actively participates during physician/clinician daily huddles using RITS Huddle Portal and huddle guide; communicates physicians/clinicians’ needs or outstanding items regarding patients.
• Enters all inpatient and outpatient elective procedures in the HITS tool.
• Ensures patients  external missed appointments are rescheduled and communicated to the physician/clinician.
• Participates in Super Huddle and provides updates on high-priority patient referrals.
• Addresses referral-based phone calls for the Primary Care Physicians panel.
• Completes and addresses phone messages within 24 hours of receipt.
• Checks out patients based on their assigned physician/clinician; if the assigned Care Coordinator is unavailable, a colleague shall assist the patient (this does not apply to the Care Specialist).
• Retrieves consultation notes from the consult tracking tool.
• Follows up on all Home Health and DME orders to ensure the patient receives services ordered.
• Provides extraordinary customer service to all internal and external customers (including patients and Chen Med Medical team members) at all times; utilizes patient messaging tools.
• Performs other related duties as assigned.

• Must be detail-oriented, able to multi-task, and open to cross-functionally training in referrals duties.
• Ability to maintain proper phone etiquette and navigate proficiently through computer software systems.
• Team-oriented with the ability to work well with patients, colleagues, physicians and other personnel in a professional and courteous manner.
• Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks; knowledge of medical terminology, CPT, HCPCS and ICD coding is preferred.
• Knowledge of medical terminology, CPT, HCPCS and ICD coding; understanding of the company’s patient population and Medicare programs; proficiency with Microsoft Office Suite and related tools; bilingual is a plus.

• High School diploma or equivalent required
• Minimum of 1 year of referral experience in a healthcare setting required
• Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred
• Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred
• Healthcare experience within the Medicare Advantage population preferred
• Medical Assistant certification preferred
• CPR for Healthcare Providers is preferred

$17.0 - $24.26 Hourly

The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience,…