Referral Coordinator Boston, MA

Who we are: Gather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology Gather Healths solution drives substantial care outcomes by addressing the whole person needs of our target demographic: older dual eligible adults the fastest growing government segment. To address the needs of these clinically and socially complex patients Gather Healths Social Primary Care solution is comprehensive and wholistic in nature encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients.

Gathers model achieves superior care by individualizing care and is reinforced by a three-prong approach: a unique care model quarterbacked by PCPs and supported by multi-disciplinary care teams tailored Social Care Plans that are led by Gather Guides and facilitated by deeply rooted community partners and a proprietary Tech Enabled Home Model.

Founded in 2022 and born out of the Healthcare Foundry Portfolio Gather Health is addressing a $1 trillion market in primary care for older adults. Today Gather Health operates in Massachusetts and is working with a multitude of payer partners on aligning value-based care economics to deliver integrated care. Gathers leadership team has a track record of building and scaling innovative primary care platforms focused on vulnerable populations including VillageMD and Commonwealth Care Alliance. Gather has raised $30M backed by Maverick Ventures Khosla and HC9 Ventures.

What is this role about

The Referral Coordination Partner will play a vital role in connecting our patients with specialists and other providers outside of Gather Health and ensuring a seamless process. There are many aspects that require coordination that can be confusing to the patients things such as scheduling a date and time running insurance verifications obtaining/sending electronic medical records from/to other clinics/hospitals etc. and the Referral Coordination Partner will be the central organizer in all activities related to referrals for our patients.

What are some of the day-to-day duties

• Schedules and pre-registers patients for exams and procedures with specialists and providers outside of Gather Health and confirms those scheduled appointments with specialists and providers
• Notifies patients of appointment information including date time location etc.
• Communicates with patients with regards to their transportation needs; contacts insurance carriers to verify transportation benefit eligibility and coordinate accordingly
• Ensures patients external missed appointments are rescheduled and communicated to the clinical care team
• Uses Web resource portals such as Availity and OneSource to generate authorizations
• Work through the denials/appeals process with Gather Health providers
• Coordinates authorizations and acquisition of Durable Medical Equipment
• Participates in daily and weekly clinical care team meetings
• Communicates with the clinical care team to ensure patients referral needs are met
• Addresses referral-based phone calls and messages in a timely fashion
• Retrieves consultation notes test results and medical records - submits appropriate clinical documents to specialist offices and uploads documents into electronic medical record platform (Athena)
• Provides backup support for front desk duties as necessary
• Performs other related duties as assigned

What are the requirements for this position

• Minimum of one year experience coordinating referrals in a medical clinic
• High school diploma or G.E.D.
• Minimum of one year experience working with an Electronic Health Record software
• Solid understanding of medical terminology
• Strong interpersonal skills with experience working in settings requiring frequent communication via phone and in-person
• Experience with basic office tools such as email Outlook calendar Excel Slack/Teams etc.
• Strong verbal written and reading comprehension skills in English
• Proven track record of detail orientation and the ability to multi-task in a busy clinic
• Ability to work from 8am to 5pm Monday through Friday
• Ability to work from home for part of the time with appropriate setup conducive to performing work including phone calls
• Ability to work for any employer in the United States

What are the preferred nice to have requirements

• Experience with CPT and/or ICD coding or HCPCS
• Experience with seniors under-served populations individuals with disabilities or other complex social needs
• Experience working in a primary care clinic setting
• Experience working with Athena

What are the traits of someone most likely to succeed in this role

• Organized manages time effectively and operates efficiently
• Motivated thrives in a busy environment
• Friendly people enjoy their company because of their joyful nature
• Compassionate they treat people with kindness
• Patient they are not easily frustrated or flustered
• Resourceful they are creative when it comes to problem solving
• Positive sees glass as is half full vs. half empty
• Reliable takes responsibilities seriously and always shows up on time

What are the hours for this position

Monday Friday during standard business hours.

Why should I join Gather Health

• We are a mission-based organization that is passionate about changing the way seniors experience primary care
• Our business model is unique and on the cutting-edge of the primary care industry
• Our leadership team is comprised of experienced individuals who are committed to creating not only the best patient experience but also an amazing employee experience for our colleagues
• We are intentionally building a strong company culture and providing a compassionate and joyful work environment
• The organization was conceptualized founded and launched by experienced co-founders with a track record of success in the healthcare space

We are committed to supporting every aspect of your life by offering a total rewards package designed to support your health financial security and work-life balance:

• Health: Comprehensive medical dental and vision with day-one eligibility
• Protection: Company-paid Life Short-Term and Long-Term Disability insurance
• Retirement: 401(k) with company match and immediate vesting
• Time Off: Generous PTO that increases with tenure and 11 paid company holidays
• Wellness: Employee Assistance Program (EAP) and supplemental benefit options

Id like to know more whats the next step

Great! An employment relationship is a two-way street as much as we want to make sure to hire the right person we want YOU to feel great about us too. Lets start by first having an exploratory conversation (via Zoom or phone) and go from there.

Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age race creed color religion sex national origin ancestry disability status veteran status sexual orientation gender identity or expression genetic information marital status citizenship status or any other basis as protected by federal state or local law.