In the role of Referral Coordinatoryou will offer inbound and outbound phone support while providing operational processingexpertiseof clinical referrals using telephony and EMR system(s) while working onsite in a central location within the market. The ideal candidate has experience in a contact center environment and can understand the needs of others to meet those needs with great service and operational processing accuracy. Knowledge of the healthcare industryincludereviewing patient charts insurance and medical billing processes and EMR/HIN systems preferred but not. The ability to have premier service interactions without patients is critical to success in this role in addition to achieving all processing performanceobjectives.

How you can make a difference

• Processes necessary prior authorizations and insurance referrals as needed to complete the referral processby using payor portal or calling the payor as needed.

• Answers all phone calls in a patient empathetic and passionately communicative manner

• Deliver on a commitment to solve problems with patience and understanding providing knowledgeable and thoughtful service to exceed expectations

• Coordinates medical specialty referralprocedures and imagingfor patients ina timely efficient andequitablemanner

• Utilizes EMR and HIN system(s) to trackresearch and document patient information ensuring accuracy completeness and compliance with organizational and HIPAA standards

• Utilizes Authman (Authorization Manager) to executeaccuratetimelyprocessingtrackingand management of patient referralsin accordance withorganizational standards

• Communicates information including updates of referral requests appointment details and communication preferences viatelephone email chat and patient portal

• Review patient charts and records to understand what authorizations and documentations need to be pursued

• Ensure that all barriers to care (such as language transportation restrictions or financial needs) are addressed

• Provides clear thorough andaccuratedocumentation of all interactions with patients and other individuals on behalf of patients in the patients electronic health records

• Maintains access to the Health Information Exchange (HIN) and other related systems

• Maintains surveillance ticklers and/or work with Health Information Technology to proactivelyidentifythe need for patient care

• Navigates patient to care as assigned

Skills for success

• A people-first attitude and premier customer service DNA

• A genuine excitement to help patients and process referrals with operational excellence

• A problem solver who can confidently troubleshoot and investigate to answer questions or resolve complaints

• Confident with system processing and updates

• Self-motivated: energetic self-starter; can work autonomously

• Ability to put yourself in patients shoes and advocate for them when necessary.

• Results oriented: bias for action;demonstratedtrack recordof achievement; drive for attainment of superior outcomes

• Flexible: ably navigates within ambiguity; solution-oriented communication; conveys thoughts and expresses ideas effectively both verbally and in writing; strong presentation skills

• Collaboration: orientation to team-based work product and results

• Service: Actively supports othersdemonstratesan optimistic can-do approach to issue resolution

• Humility: low ego; engenders trust; respectful

Experience to drive change

• Service center excellence call centerpreferred

• Experience in the medical or health insurance fieldpreferred

• Knowledge of medical terminology

• Excellent telephone etiquette

• Skilled in basic computer operations and EMR

• Bilingualin English and Spanishpreferred

• Excellent interpersonal skills including empathy patience courtesy and attentiveness

• Ability to work independently witha strong senseof focus

• Task-oriented strong organizational skills ability to multitask

• Strong attention to detail

• High school diploma or GED