Referral Clerk (24035)

REFERRAL CLERK

ABOUT US:

Laredo Technical Services Inc. provides staffing services to federal Government agencies all over the world. LTSi connects the right opportunities to the right people. With our experience in placing our Team Members throughout the United States and overseas we excel at providing experienced professional personnel for a wide range of Professional and Office Administration as well as Medical Services. Our goal is to provide the highest quality professionals in the industry.

LTSis culture delivers a strong work ethic while going above and beyond with a sense of urgency. We are an employee-driven company. We strive for excellence every day which is what sets us apart from all the other government contractors.

As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business Enterprise (MBE) that provides a broad range of administrative project management and medical staffing support services we are also honored to be a Member of the Military Spouse Employment Partnership (MSEP) and we encourage military spouses to apply for any of our positions for which they feel they are qualified.

JOB TITLE: Referral Clerk

GOVERNMENT AGENCY & LOCATION:

Naval Medical Center Portsmouth - VA

POSITION TIMING: Immediate hire upon completion of all background and security investigations.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

The responsibilities include but are not limited to:

• Manage all specialty care and Right of First Refusal (ROFR) referrals/consults per current DHA TRICARE and MTF policies.
• Ensure referrals are appointed to the MTF/Direct Care System within Access to Care (ATC) standards or referred to the local network.
• Document patient responses in MHS Genesis Referral Management System (RMS) and Health Artifact and Image Management Solution (HAIMS).
• Notify referring providers when patients request referral cancellations.
• Contact provider offices to confirm if patients were seen and obtain referral results.
• Properly close referrals in MHS Genesis and RMS and notify the referring provider or Primary Care Manager (PCM).
• Assist with the return of completed consult reports to civilian providers for patients seen under ROFR.
• Process ROFRs within TRICARE Operations Manual guidelines.
• Utilize software applications such as MHS Genesis DEERS Message Pool/Center RMS HAIMS and Microsoft Office (Outlook Word Excel Access).
• Conduct the Consult/Legible Report (CLR) process including researching processing uploading to HAIMS and forwarding to providers/PCMs.
• Notify MTF providers when CLRs are posted and monitor their timeliness.
• Chase (retrieve) delinquent CLRs from network providers.
• Validate CLR receipt and cross-check referral authorizations with adjudicated claims.
• Ensure all network referral CLRs have correct disposition or are properly annotated as non-appointed.
• Track consult updates or status changes and document customer feedback in applicable systems.
• Complete referrals within the MTF and provide guidance to correct errors and advise on referral tracking procedures.
• Generate periodic reports on referral accuracy closure and results from network referrals.
• Process referrals from the TRICARE Regional Contractor accepting or denying per MTF guidelines and SOPs.
• Maintain a customer-focused approach in all referral-related tasks.
• Maintain suspense files for network-deferred referrals and compile data for tracking and reporting.
• Submit monthly workload statistics reports to the COR by the 5th business day of each month including CLR volumes.

QUALIFICATIONS:

• Six months experience in a medical office setting
• Typing 50 wpm

EDUCATION:

• High school diploma

OPERATIONAL HOURS:0700 through 1630 Monday through Friday with a 30 minute meal break.

BENEFITS:

• Competitive salary based on experience and technical qualifications (This one only for overseas)
• Health Dental and Vision insurance
• 401(k) Retirement Plan
• Vacation
• Sick Leave
• Disability & Life Insurance
• 11 Paid Federal Holidays including:

• New Years Day
• Martin Luther King Jr. Day
• Presidents Birthday
• Memorial Day
• Juneteenth
• Independence Day
• Labor Day
• Columbus Day
• Veterans Day
• Thanksgiving Day
• Christmas Day

Laredo Technical Services Inc. (LTSi) is an Equal Opportunity/Affirmative Action Employer. We make employment decisions based on merit and qualifications ensuring equal opportunity for all applicants and employees. We do not discriminate on the basis of race color religion sex national origin age disability or any other characteristic protected by applicable law.

LTSi is committed to ensuring an accessible online application process for all individuals including those with disabilities. We offer alternative application methods for candidates who are unable to complete the online application due to a disability or other need for accommodation. LTSi complies with the Americans with Disabilities Act (ADA) Section 503 of the Rehabilitation Act of 1973 the Vietnam-Era Veterans Readjustment Assistance Act of 1974 and other relevant state and local laws. If you need assistance with an application due to a disability please contact .