POSITION SUMMARY: Under general supervision from the Clinic Support Supervisor, the Referral Coordinator's primary functions are coordination, processing, scheduling and ensuring quality control through tracking and other supportive measures of medical referrals and prior authorizations for a variety of medical services/procedures for patients as requested by healthcare providers. As an integral member of the health care team, the Referral Coordinator will collaborate with other referral staff, healthcare providers, and other patient care support staff.
ESSENTIAL JOB FUNCTIONS: The list that follows is not intended as a comprehensive list, but rather to provide a representative summary of the major duties and responsibilities. Incumbent(s) will be required to perform a variety of duties listed, including but not limited to:
- Works as a team with other staff to provide the best patient experience, including but not limited to cordial customer service, teamwork with other work units and collaboration within front and back-office support team.
- Gathers pertinent information as needed via EHR and/or from clinical team to accurately complete, process, and track referrals in a timely manner.
- Accurately and effectively utilizes third party payer/insurance portals;
- Works with provider and nursing staff to ensure the proper use of CPT and current ICD codes to meet the requirements of third-party payers and specialty clinics.
- Assists in scheduling and confirming referral appointments directly with healthcare specialists on behalf of patient.
- Responsible for referral report management and reporting to supervisor.
- Organizes and prioritizes workload based on assessing and prioritizing patient care and business needs
- Other duties as assigned
All NVIH employees are expected to:
- Provide the highest possible level of service to patients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by current NVIH's policies and procedures.
Experience and Skills
REQUIRED QUALIFICATIONS
The following knowledge, skills, and abilities are required for an employee to successfully perform their duties.
- High School Diploma or equivalent, General Education Diploma (GED).
- One (1) year Customer Service or clerical office experience required; previous experience working in a similar healthcare setting preferred.
- Proven ability to provide excellent customer service by anticipating customer needs and leaving them feeling satisfied with their experience.
- Ability to sufficiently communicate medical terminology to patients, healthcare providers and insurance company representatives regarding appointments, services and procedures.
- Able to effectively communicate both verbal and written to serve the needs of the clinic colleagues/patients/clients/visitors in a manner that is efficient and productive.
- Demonstrates a high level of interpersonal skills, time management skills, and an ability to meet established productivity standards both independently and in a team environment.
- Computer skills that provide the ability to efficiently use the computer systems to complete duties such as scheduling, updating information, and word processing and tracking documents, including the electronic health record system.
- Familiarity with HIPAA/HITECH regulations and other privacy laws and regulations to provide confidentiality of all protected information and ability to comply with NVIH Privacy rules.
- Reliable Transportation and ability to adhere to regular attendance.
Indian Native Preference. Preference in filling vacancies will be given to qualified Indian Native applicants in accordance with Native Preference in hiring practices. In other than the above, Northern Valley Indian Health, Inc., is an Equal Opportunity and At Will Employer.
Native Preference: Preference in filling vacancies will be given to qualified Native candidates, in accordance with the Native Preference in hiring practices. In other than the above, NVIHis an Equal Opportunity and At Will Employer.
Job Benefits
- Medical, Dental and Vision Insurance
- Generous PTO Accrual
- 14 paid holidays
- 401(k) w/ employer match
- Long Term Disability and Life Insurance