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Referral Coordinator

Job Description - Referral Coordinator

SUMMARY:


Managing, tracking, and monitoring of outgoing and internal referrals to ensure patient safety, care coordination and continuity of care; Assists with healthcare access to manage patient care.



POSITION DUTIES:



  1. Knowledge and understanding of Employee Handbook.

  2. Carry out the meaning of the CSMD Mission and Vision statements.

  3. Practice a culture of safety to reduce or prevent risk of injury, claims, loss or liability by utilizing the Risk Management and Infection Control Plan.

  4. Perform responsibilities with a high-quality standard to yield improved compliance, quality, and patient outcome measures by adhering to the Quality Improvement Plan.

  5. Be present and ready for work as scheduled.

  6. Attend in-service trainings, departmental meetings, and community events.

  7. Work cohesively with team members.

  8. Maintains a database of health center referral contacts throughout Baton Rouge and CSMD service areas, specifically within agencies providing health and social services to patients.

  9. Acts as liaison to hospitals, specialty clinics, other providers outside of CSMD to track and monitor referrals.

  10. Coordinates referrals to health services based on provider's orders.

  11. Ensures that all documentation is completed and in the electronic medical record (EMR)

  12. Maintains updated referral resources

  13. Upholds and completes referrals to ensure the entire referral process is complete

  14. Initiates authorizations for referrals through insurance payors

  15. Ensure that referrals are addressed in a timely manner

  16. Outreach to patients and health agencies on status of referrals

  17. Works closely with Health Information Technology department and Care Coordination to ensure timely coordination of care.

  18. Works closely with Clinical Care Team to assist with coordinating appointments for patients

  19. Promptly reviews all incoming referrals for "critical need" or attention required immediately by the provider.

  20. Adheres to all CSMD policies and procedures.

  21. Other job duties as assigned.



REQUIREMENTS:


Education:



  1. Minimum of high school diploma

  2. Preferred Certified Medical Assistant or Licensed Practical Nurse or associates in a health field

  3. Minimum of three years of experience with working referrals;

  4. Demonstrates a high level of skill at building relationships and providing excellent customer service

  5. Inhibits a strong attention to detail and accuracy

  6. Has the ability to utilize computers for data entry and information retrieval

  7. Demonstrates knowledge of the referral process for a variety of insurance plans

  8. Demonstrates success in researching and resolving complex issues

  9. Must have strong written and verbal communication skills.

  10. Must have pleasant telephone etiquette; ability to deal tactfully and effectively with patients; must have strong computer skills, use of Microsoft applications and familiarity with electronic health records.

  11. Must be critical-thinking and detailed-oriented.



SUPERVISES


N/A



TRAINING


Relias Track A Non-Clinical


Relias CareSouth Onboarding



PERFORMANCE MANAGEMENT EVALUATION TYPE


Patient Engagement



PHYSICAL REQUIREMENTS:



  1. Visual acuity - always

  2. Hand – eye coordination – always

  3. Manual Dexterity – always; fine manipulation of keyboard

  4. Lifting approximately 10-15 lbs.,

  5. Pushing, Pulling - sometimes

  6. Stooping, Bending, and Standing - sometimes

  7. Walking- frequent; short distances



WORK ENVIRONMENT:



  1. Indoor, environmentally controlled

  2. Exposure to disease or infections

  3. No vibrations

  4. Exposure to artificial and/or natural light

  5. Exposure to outdoor weather elements

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