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PrimeCare Community Health
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Referral Coordinator
$39k-47k (estimate)
Full Time | Ambulatory Healthcare Services 9 Months Ago
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Access Community Health Network is Hiring a Referral Coordinator Near Chicago, IL

Job Title: Referral CoordinatorFLSA Status: Non-exemptBilingual (English & Spanish) RequiredGrade: N/ADepartment: OperationsTitle of Supervisor: Manager, ReferralsDate: June 2023Position SummaryThe Referrals Coordinator is responsible for working within the Epic system and insurance portals to process all ACCESS referrals that are generated by the clinical providers, to ensure that the patient is being referred to the appropriate in-network provider, and that the services are approved as stipulated by the patient’s current benefit plan requirements.Core Job Responsibilities• Work with Payors/Plans to process referrals/authorizations to completion according to policy and procedure.• Assist Access Clinic providers/staff in identifying appropriate in-network providers for referred services.• Assist patients with questions regarding referrals.• Coordinate with other departments and facilities to ensure appointments are scheduled and patients have received the necessary information for their appointment(s).• Work/address the referrals that remain open to determine if patient received the referred services. Contact Referred to provider to obtain consultation notes. Contact patients per established policy and procedure to ensure they receive referred services. Close referrals per established policy and procedure.• Build and maintain relationships with Payor/Plan representatives and ACCESS clinic providers and staff; acts as a resource to answer questions and solve problems• Maintain accurate information regarding what services require prior authorization for each Payor/Plan.• Maintain accurate information regarding which external providers are contracted with each Payor/Plan.• Monitor for delays in the prior authorization process and works with the Prior Authorization Department to ensure timely scheduling.• Monitor referral phases to maintain compliance• Monitor referral dashboards and work queues daily• Perform other duties as assigned.Requirements/Preferences • High school diploma or GED required• Minimum 1-year experience in a clinical office or health care environment in patient registration, referrals, medical assisting or customer service required.• 1-year EHR Systems experience, preferred, EPIC a plus• Bilingual/Spanish preferred• Beginning proficiency Microsoft Office Suite (Word, Excel, Outlook)Competencies/Behaviors• Strong customer service orientation• Communication - strong written, oral, and presentation skills; share information that aligns with audience needs (especially via phone)• Organization – organize and prioritize duties and responsibilities; effective multi-tasking, detail oriented, accurate• Interpersonal skills –interact with patients and staff in a friendly and respectful manner; approachable• Problem Solving - identify/define problems; gather data, establish facts, and draw valid conclusions escalate issue to manager when appropriate• Collaborative; work within a team• Flexibility/adaptability - flexibility on the job, readily respond to changing circumstances, expectations and changing work demands• Emotional Intelligence - exhibits confidence, empathy and respect when communicating with customers (patients), leadership and staff• Cultural competency – experience and ability to work in a multi-cultural environment; shows respect and openness towards individuals whose social and cultural background is different from one’s own.Working Conditions/Equipment• Health Center environment• Remote working options; must have a suitable and secure remote working environment• Ability to sit for up to 4 hours at a time• Computer/laptop• Phone/Fax/Copier/ScannerEMPLOYEE EXPECTATIONSFollowing are guidelines of expectations for all employees of this organization. These guidelines are incorporated as part of your job description.➢ Maintain current knowledge in your area of skill and expertise and strive to improve your own work.As an employee you are expected to do the following:➢ Report to work on time as scheduled. You should be at your work assignment ready to begin work at scheduled starting times. Observe break times appropriately.➢ Be courteous, friendly, helpful, and supportive. Use a person’s name and use such phrases as “please,” “thank you,” and “may I help you?” whenever appropriate.➢ Make efficient use of your time at work. Establish priorities with your supervisor and use your time wisely.➢ Promote team spirit. Work together and cooperate in an effort to promote quality client services and enhance staff relationships. Help fellow staff members perform their work. Share responsibilities. Recognize others’ achievements➢ Communicate effectively. Be open, honest, and truthful with yourself and others. Talk to your supervisor. Ask questions. Give your supervisor pertinent information, stating the facts without concealing or exaggerating.➢ Anticipate and meet client needs. Be observant of and react to individual client needs. Client dignity is of primary importance.➢ Maintain an appropriate appearance. Make sure clothing is clean and you are neatly groomed. It is important to portray a positive image.➢ Participate in making quality of work better. Suggest improvements to your supervisor. Help others learn correct procedures. Be open to new ideas and methods.➢ Know the structure, philosophy, and purpose of the organization. Know how you fit into the structure and purpose of the organization. Maintain and promote the philosophy of the organization.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ambulatory Healthcare Services

SALARY

$39k-47k (estimate)

POST DATE

08/31/2022

EXPIRATION DATE

05/22/2024

WEBSITE

achn.net

HEADQUARTERS

CHICAGO, IL

SIZE

500 - 1,000

FOUNDED

1993

CEO

C MICHAEL SAVAGE

REVENUE

$50M - $200M

INDUSTRY

Ambulatory Healthcare Services

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About Access Community Health Network

Access Community Health Network (ACCESS) offers patient-centered, preventive and primary care services to more than 175,000 patients annually in the Chicagoland area. With 35 Joint Commission-accredited community health centers, ACCESS is one of the largest networks of federally-qualified health centers in the nation. All health centers have been recognized by the National Committee for Quality Assurance (NCQA). For more information, visit www.achn.net.

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The following is the career advancement route for Referral Coordinator positions, which can be used as a reference in future career path planning. As a Referral Coordinator, it can be promoted into senior positions as an Admitting Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Referral Coordinator. You can explore the career advancement for a Referral Coordinator below and select your interested title to get hiring information.

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If you are interested in becoming a Referral Coordinator, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Referral Coordinator for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Referral Coordinator job description and responsibilities

Performs data collection and data entry, following through and documenting the interaction.

01/02/2022: Newark, NJ

Make patient referrals and assist with medical services.

01/12/2022: Madison, WI

Provides referral and authorization services to the benefit of the patient's medical necessities as directed by a physician (s).

12/20/2021: Orange, CA

Ensures patients have been cleared for specialty service office visits.

01/21/2022: Wilmington, DE

Referral coordinators set appointments and process transfers to ensure timely transmission and start of services.

02/02/2022: Schenectady, NY

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Referral Coordinator jobs

Ability to work independently and be self-directed and flexible.

02/08/2022: Concord, NH

Effective telephone skills.

01/28/2022: Winston Salem, NC

Ability to work at a high-volume level of accuracy.

03/01/2022: Portland, ME

Strong level of confidentiality due to the sensitivity of materials and information handled

02/06/2022: Seattle, WA

Must be able to make suggestions on workflow or system efficiency and effectiveness.

12/21/2021: Boca Raton, FL

Step 3: View the best colleges and universities for Referral Coordinator.

Butler University
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