Referrals and Call Center Navigator

Fair Haven Community Health Care

FHCHC is a forward-thinking dynamic and exciting community health center that provides care for multiple generations at over 143000 office visits in 21 by a Board of Directors the majority of whom are patients themselves we are proud to offer a wide range of primary and specialty care services as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access we continue to put our patients first in everything we do. The mission of FHCHC is To improve the health and social well-being of the communities we serve through equitable high quality patient-centered care that is culturally responsive.

For 53 years we have been a health care leader in our community focused on providing excellent affordable primary care to all patients regardless of insurance status or ability to pay. Fair Haven is proud to have a motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients.We believe that everyone should have access to high-quality medical and dental care regardless of ability to pay.

Job purpose

To assist clinicians and patients in managing specialty and diagnostic referrals and schedule appointments and perform tasks in medical records. When necessary navigates patients through the health care system from the initiation of the referral to obtaining prior authorization scheduling appointments and tracking and following up on results.

Duties and responsibilities
This hybrid position works both in the call center and referrals department as needed. Typical duties include but are not limited to:

• Works in close partnership with the clinical teams to manage all aspects of external referrals and obtains prior authorization for referrals when necessary.
• Makes appointments and any additional referral arrangements with patient referral sites.
• Documents all aspects of the referrals process in the patients Electronic Health Record and communicates with referring clinicians when patients cannot be reached.
• Educates patients related to requirements of referrals referral sites/ locations and/or appointment specifics.
• Works to identify performance improvement needs and strategies for managing tracking and following up on referrals.
• Manages a system for follow up of referrals by maintaining a searchable database.
• Works with teams and individual providers to clarify access issues or other barriers for particular referrals or groups of referrals.
• Familiarizes self with and acts as an expert related to insurance practices and coverage or referrals by various payer sources.
• Ensures patient confidentiality and provides patients with needed information.
• Schedule utilize triage referral guidelines and script usage to assist patients who call into the call center.
• Answer multi-line telephone system screen and direct telephone inquires via EHR to the appropriate person in an efficient manner while utilizing Call Center documented workflow.
• Accurately acquire confirm and input and update patient demographic information. .
• Performs other necessary duties as required by FHCHC to achieve the goal of providing high quality services and primary health care.
• Providing coverage for departments under operations portfolio (i.e. front desk) as necessary including extended leaves

Qualifications

• High School diploma or GED is required. An Associates degree is highly preferred. Minimum of one to two years ofexperience in a high volume medical officecall centerand referrals experience highly preferred.
• Electronic appointment scheduling and data entry experiencerequired. Exceptional phone etiquette incorporating strong communication interpersonal and customer service skills a necessity. Strong critical thinking and problem solving skills with the ability to work as a member of the team to serve patients is a must.
• Bilingual in English and Spanish is required.

American with Disabilities Requirements:

External and internal applicants as well as position incumbents who become disabled must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race religion color sex gender identity sexual orientation age non-disqualifying physical or mental disability national origin veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications merit and business need.