The Care Coordinator (Referrals Coordinator) is a highly visible customer service and patient-focused role that works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to our members.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Coordinates and processes patient referrals to completion with precision, detail and accuracy.

Definition of completion:

• Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
• Orders have been approved (when needed).
• Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
• Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
• Completes orders with proper documentation on where patient is scheduled and how patient was notified.
• Referrals have been sent to specialist office & confirmed receipt.
• Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide. Communicates effectively the physicians/clinicians needs or outstanding items regarding to patients.
• Enters all Inpatient and Outpatient elective procedures in HITS tool.
• Ensures patient's external missed appointment are rescheduled and communicated to the physician/clinician.
• Participates in Super Huddle and provides updates on high priority patients referrals.
• Addresses referral based phone calls for Primary Care Physicians panel.
• Completes and addresses phone messages within 24 hours of call.
• Checks out patients based on their assigned physician/clinician. (Note: If assigned Care Coordinator is unavailable at the time of check out, a colleague shall assist patient. This process does not apply to Care Specialist)
• Retrieves consultation notes from the consult tracking tool.
• Follows up on all Home Health and DME orders to ensure patient receives services ordered.
• Provide extraordinary customer service to all internal and external customers (including patients and other
• ChenMed Medical team members) at all times. Utilization of patient messaging tools.
• Performs other related duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

• Must be detail-oriented, possess the ability to multi-task and be open to cross-functionally training in referrals duties.
• The individual in this role must exercise proper phone etiquette and have the ability to navigate proficiently through computer software systems.
• Must be team-oriented and work extremely well with patients, colleagues, physicians and other personnel in a professional and courteous manner.
• Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks. Knowledge of medical terminology, CPT, HCPCS and ICD coding preferred.

EDUCATION AND EXPERIENCE CRITERIA:

• High School diploma or equivalent required.
• Up to one (1) year of relevant work experience required. Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred. Healthcare experience in a clinical setting, preferably within the Medicare HMO population is a plus.
• CPR for Healthcare Providers is preferred. A valid driver's license in State of employment is required; position may require travel within the market.

Job Type: Full-time

Pay: $17.00 - $21.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday
• No weekends

Application Question(s):

• Do you have experience with Availity?

Education:

• High school or equivalent (Preferred)

Experience:

• Medical Office: 2 years (Preferred)
• Referral Coordinator: 2 years (Preferred)
• Web IVR's: 1 year (Preferred)
• Authorizations: 2 years (Preferred)

Work Location: In person