Position Title: Referral Coordinator

Department: Medical

Position reports to: HIM Manager

Status: Union

Position Summary:

The referral coordinator maintains and updates the status of incoming, outgoing, and internal referral orders created by Providers with electronic tracking processes within the clinic’s Electronic Medical Record (EMR), Health Information Exchange (HIE) tools, apps, work queues, platforms, and portals. Performs appropriate documentation, prepares medical forms such as progress notes, labs, radiology reports, procedure reports, and other related material with accuracy when coordinating the authorization request process of referrals. Coordinates quality continuity of care and treatment based on the Provider orders to ensure patient safety in a timely manner.

Adhere to Clinica Romero’s mission and core values: Compassion, Commitment to Service, Quality Care, Respect, and Dignity; and complies with all policies and procedures of the organization.

Responsibilities:

• Upholds Clinica Romero’s Policies and Procedures, HIPAA, Compliance, Principles of responsibilities, and applicable state, federal, and local laws.
• The referral coordinator works in collaboration with assigned providers, medical staff, medical offices, specialists, referral coordinators and other programs and agencies such as: IPAs, DHS eConsult, EWC, BCCTP, and/or others.
• Communicates clearly in order to promote patient engagement and education based on recommendations given by their health care providers and specialists. Answer and screen Referral Department phone calls, messages, correspondence, and queries.
• Maintains and updates the status of incoming, outgoing, and internal referral orders created by Providers with electronic tracking process on an ongoing basis within the EPIC EMR referrals module in conjunction with other Health Information Exchange tools such as LANES Portals, WELL APP, DHS eConsult platform, MedPoint Management and Preferred IPA portals, DHS Medi-Cal EWC, EWC DETEC Database on-line Reporting portal, CareEverywhere, EPIC Referrals module, and EPIC secure chat and In-Basket tools.
• Process assigned Provider Referral Orders based on linked services and/or programs such as MHLA, EWC, Fam Pact, BCCTP, health plans, Medi-Cal, Medi-care and/or other products, records, and Referral procedure and/or specialty with diagnosis and notes generated by the ordering Provider.
• Through automatization workflows, Referral Coordinator performs Tracking of Authorizations, generates, sends correspondence, and referral notification updates through approved EPIC electronic Referral Letter templates, WELL App messages, mail, secure email, fax, assigned eFax account, telephone encounters, IPA portal inquires, eConsult messaging system, and EWC DETEC.
• Maintains clear communication in regards to the Referral status, updates the referral reason codes, scans and/or imports/exports specialty Provider reports received, and forwards to assigned Providers for review, e-signature, and/or for further additional referral orders as well as with Patients, Specialty Clinics, IPAs, and/or other external and internal customers through EPIC Secure Chat, Epic In-Basket Messaging, telephone encounters, WELL App, secure email, fax, assigned eFax account, mail, and updates the EPIC Referral Module Notes sections for compliance and for internal and external audit purposes.
• Flags Referral Order deficiencies and notifies provider and appropriate personnel through EPIC In-Basket Message, EPIC secure chat module, and email and/or through other channels of communication in order to obtain review and electronic signatures for review and completion of the referral loop workflow.
• Perform as a patient advocate and liaison for specialty providers and social service referrals through the Transitions of Care Referrals workflow by coordinating Place of Service, Referral Class, and Referral Reason modules and by providing Summary of Care Documents.
• Provides Breast and Cervical Cancer diagnosis, screen date, diagnosis date, screened by, and diagnosed by information based on ordering provider referral order to back office, front office, and eligibility staff prior to their portion of coordination of the enrollment and application process for the EWC Program, BCCTP Program, and/or with other Clinica Romero initiatives such as Breast Exam Events and/or other programs.
• Notify Referrals Manager and Informatics Specialist regarding issues of connectivity and when an external provider/POS needs to be added and/or updated within the EPIC Referral Module.
• Establishes and maintains courteous, cooperative relations when interacting with all agencies, patients, clinic and department personnel, and the public. Assures timeliness of services rendered to patients and looks after their comfort while on premises.
• Maintains and reports data logs of abnormal mammograms (Immediate Work-Ups) to the Director of Revenue Cycle/Business Development for EWC Cancer Program Detection Reporting.
• Provides coordination of appointment services, tracking, reports, and notifications for programs associated with Clinica Romero, such as EWC Cancer Detection Program recipients for Hollywood Presbyterian and/or White Memorial and/or other EWC providers based on Provider Orders.
• Maintains Transaction Services in the Medi-Cal DETecting Early Cancer (DETEC) data submission system for reporting and program compliance purposes as well as the interaction and retrieval of reports and updates within Renaissance, Larchmont, UMI, CHLA, and other portals.
• Generate and route data forms and reports to appropriate destination (billing, medical records, etc.).

Qualifications/Requirements:

• High School diploma required. College degree preferred or equivalent of three years health care professional experience
• Experience with the usage of Electronic Medical Records Systems.
• Knowledge Office equipment use such as Computer, Scanner, Fax, Email, eFax, Telephone, electronic communication platforms and/or upload platforms
• Bi-lingual English/Spanish
• Customer service skills: communication, empathy, patience, and technical knowledge
• Work in team-oriented environment, and work well under deadlines.
• Ability to handle multiple tasks and work in a busy environment including heavy telephone duty.
• Willingness to travel when required; must maintain a current CA driver’s license and vehicle insurance