Community Information Specialist - Referral Specialist

Multnomah County•Portland, OR

54d•Hybrid

About The Position

This is an internal job posting for former Multnomah County employees on an active recall list. The Multnomah County Health Department is seeking a highly organized and community-focused Community Information Specialist to join their clinic team. This critical role involves managing the complete patient referral process, directly supporting providers and patients. The specialist will proactively manage and coordinate patient accounts, ensuring seamless and accurate information exchange throughout the referral process. This position is essential for guaranteeing the diverse client population receives the specialized care they need by building strong partnerships with external healthcare providers and insurance companies. The position follows a hybrid telework schedule, with one day in the clinic, contingent on meeting program KPIs.

Requirements

Education/ training equivalent to an associate's degree
One (1) to four (4) years of relevant experience that demonstrates the ability to perform the duties of the position.
Must pass a reference check.

Nice To Haves

Previous experience with EPIC
Adaptable to change
Demonstrated ability to professionally and effectively communicate orally and in writing with a variety of people, answering questions and explaining technical information.
Experience or ability to synthesize data in order to independently solve problems or formulate recommendations.
Ability to organize, prioritize and complete a variety of simultaneous tasks.
Experience working with culturally and individually diverse groups.
Demonstrated experience effectively navigating state and federal agency laws, programs, policies, and/or procedures.
Deep understanding of and experience addressing the systemic barriers that perpetuate disparities for community members who experience marginalization.

Responsibilities

Determine reimbursement sources and navigate complex pre-authorization protocols as required by specialty care providers and insurance companies through coordination with internal and external stakeholders.
Complete required documentation, processes and track referrals based on criteria; act as a liaison with Primary Care Access and Referral for self-pay referrals.
Coordinate with the Oregon Health Plan (OHP) Eligibility Specialist, using MMIS and PHTech to assess insurance coverage levels and evaluate which specialty clinic best meets client needs.
Track and close referrals per policy; provide weekly updates to providers according to current workflow standards regarding high-risk referrals in process; follow-up on outstanding reports.
Consult and advise providers concerning difficult referral situations; act as a liaison between client, parent/guardian, provider, specialty office and insurance provider, if applicable.
Provide assistance to the public by phone or in person for referral questions; collaborate with provider teams to support integrated and coordinated specialty care in order to assist families/clients to meet their primary care needs.
Research and problem solve issues or conflicts related to service access and reimbursement.
Provide clinical operations support to the team as requested in the area of paper flow and faxing, certified mail, research, and reports.
Create Reporting Workbench Reports that provide feedback regarding referral workqueue classifications, productivity, and referral volume; assist in maintaining electronic documents for distribution and publication.
Collaborate with Clinical Information Systems (CSI) to ensure patient record accuracy and identify any electronic health record (EHR) issues.
Assist in the review of Quality and Compliance related issues for primary care and dental referrals within the Health Center.
Assist in the review and assessment of project/program effectiveness and services provided through contract resources.
Maintain inventories of information materials; participate in clinic presentations and in-service training sessions designed to enhance the strategic planning and programmatic goals of the referral program.
Participate and lead meetings and training seminars relating to patient education regarding referrals, provider onboarding, and specialty clinic updates.