Job Summary:
Under the supervision of the Scheduling Manager, the Referral Coordinator is the first point of contact for all outgoing participant referrals. Position is responsible for managing and processing all authorizations and referrals as requested by the PACE practice physicians for outside diagnostic testing, specialty provider referrals, and other ancillary services. This individual will serve as a liaison between patient and medical staff. Referral Coordinator is responsible for securing authorizations timely for all outside referrals and ensures that participants are being scheduled and seen by; coordinating and tracking all outside new first time appointments.
Essential Job Functions:
Duties include, but are not limited to:
- Coordinates all outside referrals, appointments and authorizations requested by PACE practice physicians for outside diagnostic testing, specialty provider referrals, and any services.
- Schedules, tracks, and communicates with participant to ensure completion of all physician referrals for outside services and testing.
- Performs statistical tracking of referrals to ensure consistent follow through and guarantees completion of all outside patient testing, services and appointments.
- Uses customer service principles and techniques to deal with patients, physicians and medical office staff calmly and pleasantly.
- Develops and maintains positive and professional relationships with outside referral sources and facilities.
- Assures patients are given timely access to outside practices.
- Performs other administrative tasks and/or projects required to meet performance and customer services standards.
- Collaborates with Center Scheduling in performing similar duties or coverage as assigned by Scheduling Manager.
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Utilizes a computerized scheduling system and multiple software applications to complete daily functions. - Scans and uploads scheduling related documentation to the EMR.
- Utilizes EMR to monitor and process new orders daily, documents appointment statuses utilizing coherent and uniform documentation.
- Promotes a healthy and positive work environment by demonstrating workplace behavior aligned with organizational core values of respect, honesty, integrity, encouragement, patient-centeredness and quality care.
- Ensuring participants are aware of appointments and are reminded regularly.
- Identifying issues that may prevent a participant from attending scheduled appointments; and communicating solutions.
- Analyzing schedule progress and performance and identifying developing problem areas.
- Handles any necessary arrangements for client utilization, i.e. pulling records,
- Determines participant needs, scheduling, ensuring necessary equipment or supplies are available.
- Demonstrates an understanding of patient confidentiality to protect the patient and PACE organization.
- Attend and participate in staff meetings, in-services, projects, and committees as assigned.
- Adhere to and support the center’s practices, procedures, and policies including assigned break times and attendance.
- Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
- Be flexible in schedule of hours worked.
- May require use of personal vehicle
Performance Requirements:
Knowledge:
- Knowledge of medical terminology, authorization and referral processes.
- Intermediate knowledge of MS Office, Word and Excel.
- Bilingual- English/Spanish/Hmong speaking preferred.
Skills:
- Skill in organizational techniques including time management, prioritization, multitasking and problem solving.
- Exceptional interpersonal communication skills required.
- Knowledgeable as an advocate for risk-based long-term care programs, specifically the PACE model.
Abilities
- Ability to read, understand and follow oral and written instructions.
- Ability to use multi-line phone system, including transferring calls.
- Ability to provide consistent follow through to guarantee completion of all outside patient testing, services and appointments.
- Ability to establish and maintain effective working relationships with patients, physicians, other clinical staff and the public.
Working Conditions and Physical Demands
The working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ability to access all areas of the center throughout the workday.
- Involves sitting approximately 80 percent of the day, walking or standing the remainder.
- Some bending, stooping, and must be able to lift up to 25 pounds.
- Ability to communicate verbally with an excellent comprehension of the English language.
- Work is generally performed in an indoor, well-lighted, well-ventilated, heated, and air- conditioned environment.
. Requirements:
Experience
- Minimum of two (2) years of experience in an administrative capacity (scheduling, referrals) in a health care setting, preferably in a managed care environment.
- Minimum of one (1) year of documented experience working with a frail or elderly population.
Education and Certification
- Associate’s degree or certification health administration related field preferred.
- An accredited Medical Assistant Course with Certificate of Completion preferred.
- Is medically cleared for communicable diseases and has all immunizations up-to-date before engaging in direct participant contact.
In accordance with California State mandate, Innovative Integrated Health has a mandatory vaccination policy requiring COVID-19 vaccination for all employees. For any potential exemption from this requirement contact the Human Resources Department.
Source: Indeed.com
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