Care Coordinator (Referrals Coordinator)

ChenMed

20h•Onsite

About The Position

The Care Coordinator (Referrals Coordinator) is a highly visible customer service and patient-focused role that works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to our members.

Requirements

Must be detail-oriented, possess the ability to multi-task and be open to cross-functionally training in referrals duties.
The individual in this role must exercise proper phone etiquette and have the ability to navigate proficiently through computer software systems.
Must be team-oriented and work extremely well with patients, colleagues, physicians and other personnel in a professional and courteous manner.
Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks.
High School diploma or equivalent required.
Up to one (1) year of relevant work experience required.
A valid driver's license in State of employment is required; position may require travel within the market.

Nice To Haves

Knowledge of medical terminology, CPT, HCPCS and ICD coding preferred.
Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
Healthcare experience in a clinical setting, preferably within the Medicare HMO population is a plus.
CPR for Healthcare Providers is preferred.

Responsibilities

Coordinates and processes patient referrals to completion with precision, detail and accuracy.
Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
Completes orders with proper documentation on where patient is scheduled and how patient was notified.
Referrals have been sent to specialist office & confirmed receipt.
Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide.
Communicates effectively the physicians/clinicians needs or outstanding items regarding to patients.
Enters all Inpatient and Outpatient elective procedures in HITS tool.
Ensures patient's external missed appointment are rescheduled and communicated to the physician/clinician.
Participates in Super Huddle and provides updates on high priority patients referrals.
Addresses referral based phone calls for Primary Care Physicians panel.
Completes and addresses phone messages within 24 hours of call.
Checks out patients based on their assigned physician/clinician.
Retrieves consultation notes from the consult tracking tool.
Follows up on all Home Health and DME orders to ensure patient receives services ordered.
Provide extraordinary customer service to all internal and external customers (including patients and other ChenMed Medical team members) at all times.
Utilization of patient messaging tools.
Performs other related duties as assigned.