Referral Coordinator (MA)

Job Title: Referral Coordinator

Position Class: Non-Exempt

Supervision Received: Clinical Site Coordinator

Supervision Exercised: None

Pay Range: Based Upon Experience

General Summary:

Member of CCHS Care Team responsible for coordinating all referrals from medical and behavioral health providers to specialist physicians, testing facilities or other health professionals. Referral Coordinator receives referral requests electronically, and following the CCHS standards, prioritizes the processing of the referral requests. The Referral Coordinator manages the pending requests, following up with the referral resource as necessary. The Referral Coordinator tracks pending referral requests to assure that reports are received and forwarded to the referring provider, and are documented in the patient’s medical home electronic record. The Referral Coordinator communicates with patients by telephone or in writing regarding provider orders and scheduled appointments, emphasizing the value of keeping their primary care provider aware of any changes in their care as a result of the referral and the need to have their medical home record reflect all care.

Core Duties and Responsibilities, which include the following and other duties as assigned:

• Reviews all incoming referral request tasks in the electronic health record and assesses priority following the CCHS standard for processing referral requests.

• Processes requests daily, communicating with the referral resources by telephone, fax or email to obtain appointment for the patient. Reviews patient’s insurance status and works to find referral resource for uninsured or sliding fee patients.

• Facilitates good care transition by gathering appropriate clinical information from medical home record/primary care provider and forwards to specialist physician or testing facility. Makes sure the specialist office understands the need for a timely report of all care, so that patient’s medical home record is complete.

• Obtains pre-certifications as required by patient’s third party payer.

• Documents communications with the referral resources in the electronic health record and documents in the CCHS Referral Tracking Log.

• Communicates with patients by telephone or in writing regarding appointment. Reminds patients of the need to maintain a complete “medical home record”.

• Communicates with referring provider if unable to obtain appointment or patient refuses appointment for referral.

• Manages pending referral tracking log, follows up on referral requests as necessary.

• Follows up on reports from referral resource to assure that results are communicated back to referring provider and documented in the patient’s medical home record.

• Participates in weekly Extended Team Huddles to discuss complex cases, contribute to problem solving for process and quality improvement needs.

• Maintains good working relationships with all referral resources, communicates with Operations Director regarding any changes in the CCHS Referral Resources.

Qualifications – Skills and Abilities:

To perform the Referral Coordinator successfully, the Referral Coordinator must demonstrate core competencies in the following areas:

• Basic keyboarding and PC skills, Windows skills including WORD and EXCEL

• Use of printers, copiers and fax equipment

• Navigation of a Windows based electronic health record and/or practice management system

• Proper medical documentation skills including knowledge of ICD coding

• Good communication skills for providers and other members of the Care Team

• Good communication skills for patients and care-givers, including obtaining appropriate clinical information and symptoms and giving patients instructions and education as directed by the medical provider

• Good communication skills for referral resources, including good negotiation skills in obtaining timely appointments

• Good critical thinking and problem solving skills

• Ability to self manage, including prioritization of incoming referral requests and follow-up on pending referrals

• Ability to react calmly and effectively during peak demand periods

• Ability to learn advanced training objectives as defined by CCHS

Education and Experience:

High School Graduate

Graduate of Recognized Medical Assistant Program preferred

Two Years Experience as Referral Coordinator or Two Years Experience as Medical Assistant with Referral Experience

Certificates, License, Registration:

National Certification preferred

Physical Demands:

Although most of the workday is spent sitting, other varied activities include standing, walking, reaching, bending and lifting. Requires full range of body motion, including assisting in the lifting of patients manually. The employee must regularly lift and/or move up to 20 pounds, and occasionally lift and move up to 50 pounds. Eye-hand coordination and finger dexterity. Requires corrected vision and hearing to normal range. Reasonable accommodation for disabled individuals will be considered. Working with ill patients may be stressful.

Environmental/Working Conditions:

Primary Care Health Center with combination of office and exam room settings. Frequent exposure to communicable diseases, body fluids, sharp instruments and needles, cleaning chemicals, medicinal preparations. May require working extended shifts and hours as necessary.