DescriptionThe Referrals Clerk is responsible for arranging all referrals including pre-authorizations, making appointments and contacting patients, answering telephone lines, verifying patient insurance, and providing support to the team.
Performs Essential Job Duties
- Completion of all referral requirements of various programs and managed care plans
- Verifies patient demographic status (family size, income etc.) and completes appropriate forms
- Arranges appointments with specialist office and informs primary care physician and patients of details
- Updated EMR system with status of referrals and tracks according to procedure
- Review details and expectations about the referral with patients
- Assist patients in problem solving potential issues related to the health care system, financial or social barriers
- Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient's behalf with the insurer to ensure approval of the necessary supplies/services for the patient in a timely fashion
- Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers
- Ensure that referrals are addressed in a timely manner
- Responsible for following work flows that result in capturing activities to meet patient engagement standards as outlined in the APCM program
- Other duties as assigned
Customer Service: Develops and maintains professional, support-oriented working relationships with patients, team members, and community partners. Demonstrates continuous improvement in achieving, developing and fully competent levels of employer?s Behavioral Standards.
Must be able to interact with a variety of individuals at various levels under stressful circumstances while exercising sound judgement, tact, and diplomacy; work productively both independently and in a team setting; communicate with clarity, both verbally and in writing to groups and individuals.
Education and/or Experience:
- Minimum: High School Diploma or GED equivalent
- One to three months of work experience in a medical office setting or one year of related work experience
- Excellent interpersonal communication and problem-solving skills
- Skills to intervene and promote reconciliation, compromise and positive outcomes in difficult interactions
- Skilled at using electronic health records as applicable to area of work (EPIC)
- Medical terminology
- Basic knowledge of adult learning models
Must have the ability to communicate with clarity, both verbally and in writing; read, analyze, and interpret complex documents, regulations, policies, and procedure manuals; and create professional business documents. Preferred English/Spanish.
Must have the ability to add, subtract, multiply, use percentages, fractions, decimals, interpret numeric graphs and apply basic algebra, geometry and statistics.
Must have the ability to:
- Understand confidential document security from a legal perspective
The physical demands described here are representative of those that must be met by a Referrals Clerk to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable those with disabilities to perform the essential functions.
While performing the duties, the Referrals Clerk is required to:
- Use hands to finger, handle, or feel; and talk or hear
- Frequently is required to stand, reach with hands and arms
- Occasionally required to stoop, kneel, crouch, or crawl
- Lift and move light material (<25 lbs)
Job RequirementsEducation Required: High School
Experience Required: Entry Level
Last updated on 12/04/2018
13.00 - 14.00
Are you interested in this position? Please complete our On-Line Application. Please note that your application will remain on file for 90 days for consideration for any of our open positions that match your qualifications.
If you have completed our on-line application in the last 90 days you can send a letter of interest to the recruiter hiring for this position at firstname.lastname@example.org. Please include a copy of your resume with your email or application.