Referrals Coordinator

Job Description

The purpose of this role is to review and process all diagnostic, specialty and miscellaneous referral requests from clinical staff to obtain required authorizations and assist patients to overcome financial and social barriers to care. The representative ensure appropriate documentation and timely communication to the patients for appropriate follow-up.

Essential Functions

• Demonstrate understanding of various referral requests in connecting patients to appropriate care based on his/her specific role: 1) Referral Coordinator: diagnostic, specialty, miscellaneous referrals requests; 2) Prevention Coordinator: preventative cancer screening including ultrasounds, colorectal, breast and cervical cancer.
• Reviews & processes all referral requests by clinical staff in a timely manner.
• Acts as liaison between patient, Legacy provider and all other community providers.
• Obtain and review patient’s insurance status to assess eligibility/prior authorization requirement for referrals.
• Schedule appointments, provider reminder calls and send letters as appropriate. Reviews and processes prior authorization requests by clinical staff as appropriate.
• Records all appropriate information via Centricity EHRS.
• Adheres to regulations and standards for Patient Centered Medical Home, HIPAA guidelines, and other grants as appropriate.
• Complete follow-up on obtaining referral results in a timely manner.) Participates in our Performance Improvement Program for coordination of care.
• Performs other duties as assigned.

Education & Training Requirements

• High school diploma or GED
• One year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.
• Ability to meet Legacy Community Health’s EPIC proficiency requirements.

Work Experience

• One (1) year of experience in medical assistance OR referral coordinator OR insurance verification OR medical prior authorization

Benefits

As part of values that Healthcare is a Right and not a Privilege, we offer a suite of benefits

• Medical / Vision / Dental (Costs of benefits are based on your yearly salary)Medical visit copays are waived when seeing a Legacy provider.

• 9 Holiday + 1 Floating Holiday
• 403b Retirement Plan
• Bright Horizons Back-up CareAs a user of Bright Horizons Back-Up Care, you can conveniently schedule care right from your mobile device with the Back-Up Care app– your easy, time-saving solution to managing family care challenges while on the go.

• Paid Time Off (PTO)PTO Exchange benefit

PTO Exchange will provide you with the option to convert a portion of your accrued but unused PTO hours for use toward several different benefits and causes, based on your own priorities.

With PTO Exchange, you can convert a portion of your unused PTO into:

· 403(b) Retirement contributions

· Student loan payments / Tuition for the employee

· Leave Sharing donations to fellow employees```Duties:```
- Coordinate and facilitate the referral process for clients seeking services
- Conduct initial assessments to determine client needs and eligibility for services
- Collaborate with healthcare providers, social workers, and other professionals to ensure appropriate referrals are made
- Maintain accurate and up-to-date records of client information and referral outcomes
- Provide education and support to clients regarding available resources and services
- Assist clients in navigating the healthcare system and accessing necessary care
- Collect data and generate reports on referral trends and outcomes

```Qualifications:```
- Bachelor's degree in social work, public health, or a related field (Master's degree preferred)
- Experience in a healthcare or social services setting
- Knowledge of public health programs, Medicare, and insurance processes
- Familiarity with addiction counseling and motivational interviewing techniques
- Strong communication skills, including public speaking and the ability to educate clients on available resources
- Ability to work collaboratively with a multidisciplinary team of professionals
- Attention to detail and strong organizational skills for maintaining accurate records

Note: This job description is not intended to be all-inclusive. The employee may perform other related duties as assigned by their supervisor.

Job Type: Full-time

Pay: $17.47 - $20.00 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Weekly day range:

• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Referral: 1 year (Required)
• Epic: 1 year (Required)

Language:

• Spanish (Preferred)

Work Location: In person