The Referral Clerk is responsible for coordinating all patient referrals made by Providers to appropriate specialties or for diagnostic services. The Referral Clerk will obtain and document inpatient records, receipt of certification and authorization from Third Party reimbursement companies (MCOs, HMOs, PPOs) as well as ensure providers have test results available in a timely manner. The Referral Clerk will complete all follow-up referrals.

ESSENTIAL DUTIES/RESPONSIBILITIES:

• Process and schedule the provider referrals/consults orders (i.e. EMG, CT, MRI, etc.) using electronic health record (EHR) system.
• Make sure all forms are completed with all necessary information for scheduling the referral/consult.
• Complete Prior-Authorizations, Precertification, and scheduling tests with different facilities (also includes Referral tracking log in EHR)
• Request any testing that has not been received
• Provide the patient with information about the test or procedure and any preparation required.
• Communicate to Provider when a STAT and/or Urgent referral occurs and are unable to refer patient in a timely manner.
• Demonstrate a clear understanding of the medical chart and has the ability to provide clear and accurate supporting clinical information as necessary to support the need for ordering tests.
• Demonstrate computer skills to accurately maintain provider orders based on established policies and protocols diagnosis supplied for testing is non-covered and advises patients as necessary.
• Accurately document all communication regarding appointments and status of referral in EMR telephone templates, diagnostic ordering templates, and plan templates accordingly.
• Accurately document notes into EHR regarding letters or correspondence from insurance companies, provider offices and patients.
• Track and follow-up on referral and scheduled appointments according to policies and procedures.
• Completion of referrals includes:

a. Insurance Authorizations
b. Transmission of required medical information to specialist
c. Facilitate appointment scheduling or rescheduling
d. Receipt of consult notes and attaching them to the medical record.
e. Referral tracking activities to include all elements of a referral.

f. Final referral results are received into the EMR.

· Perform all other duties as assigned in a professional and efficient manner.

POSITION REQUIREMENTS:

v Excellent communication skills and attention to detail.

v Computer knowledge.

v Ability to organize, prioritize tasks, work under pressure and meet deadlines.

v Ability to work independently and as a team member.

EDUCATION/EXPERIENCE:

v High School Diploma or equivalent. Certified Medical Assistant preferred.

v Twelve (12) months clerical experience or completion of a clerical training program.

v At least one year of experience in authorizing referrals, computer applications, and knowledgeable of medical terminology.

Benefit Conditions:

• Only full-time employees eligible

Work Remotely

• No

Job Type: Full-time

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Paid time off
• Retirement plan
• Vision insurance

Weekly day range:

• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• Authorizing Referral: 1 year (Preferred)
• Clerical: 1 year (Preferred)

Work Location: In person