REFERRAL TRACKING COORDINATOR I (TEMP - 6 MONTHS)

The Referral Tracking Coordinator (RTC) is responsible for the processing of all medical referrals initiated by NEMS PCPs from start to finish, which includes verifying patient’s eligibility and coverage information from various insurance plans, requesting prior authorizations from health plan(s), communicating with hospitals and specialty providers’ offices to follow up referral requests, scheduling appointments, confirm completion of visits by obtaining consultation notes, documenting progress in Epic EHR system to keep PCPs and care team informed.

The RTC-I is responsible for the tracking of all the in-progress medical referrals, perform additional needed activities to ensure referrals initiated by PCPs are followed through according to TAT (Turnaround Time) requirement.

This position requires good communication and public relations skills to build rapport relationship with counterpart staff at external specialist offices and hospitals to facilitate a smooth close-the-loop process. The RTC Coordinator will work collaboratively with NEMS clinical team, external provider/vendor offices and hospital staff to promote workflow efficiency and team performance.

ESSENTIAL JOB FUNCTIONS:

• Timely processing of medical referrals for all insurances, including Medi-Cal, Medicare, private insurance, self-pay, etc.
• Obtain clinical information relevant to the patient’s referral and submit a complete packet of referral documents to the external provider’s office to avoid delays in patient care.
• Track referral status and obtain consultation reports/results to close the referral loop.
• Follow-up on the outstanding referrals report and contact patients to determine if patients still need/want the requested service.
• Assist patients with contacting external provider offices or agencies to schedule appointments for the referred services.
• Provide patients with accurate information regarding the referral, including specialty type, name of the specialty provider, address, phone number, and a copy of the referral, if appropriate.
• Triage inquiries on referral status and communicate timely with the PCP care team if additional information is needed to process the referral.
• Enter all referral related activities and communications in the patent’s Electronic Medical Record, including notes and any relevant information as it relates to the referral.
• Performs other job duties as required by manager/supervisor.

QUALIFICATIONS:

• High School Degree required AA or higher preferred or can be substituted with minimum of 2 years of experience in customer services and/or healthcare related field required
• Good communication skills (both written and verbal) is required to support system documentation and progress tracking.
• Prior experience working in healthcare setting with knowledge of handling different insurance types, e.g., Medi-Cal, Medicare, private insurance, is preferred.
• Knowledge of medical terminology is a plus.
• Ability to follow directions with minimal supervision.
• Ability to multitask in a busy environment is a must.
• Strong attention to detail.
• Excellent data entry skills.

LANGUAGE:

• Must be able to fluently speak, read and write English.
• Fluent in Chinese (Cantonese and/or Mandarin) is required.
• Fluency in other languages is an asset.

STATUS AND SCHEDULE:

• This is an FLSA Non-exempt position.
• This is not an OSHA high-risk position.