Coordinator, Appointments & Referrals

East Boston Neighborhood Health Center Corporation • Revere, MA

8d • Onsite

About The Position

As an integral part of our patient service team, the Appointment and Referrals Coordinator will be primarily responsible for gathering information concerning patient’s medical needs in order to schedule appointments and securing verification from insurance companies for referral approvals. Will also the system navigator and point of contact for patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the insurance carrier to ensure approval of the necessary services for the patient in a timely fashion. HS Diploma/GED and at least 2 years of experience within a healthcare setting with knowledge of EMR systems required. Must have the ability to understand and interpret various managed care insurance benefits and guidelines.

Requirements

• HS Diploma/GED and at least 2 years of experience within a healthcare setting with knowledge of EMR systems required.
• Ability to understand and interpret various managed care insurance benefits and guidelines.
• Experience in a health care setting – at least one year
• Knowledge of, and experience with medical terminology extremely helpful
• Working knowledge of the health center’s computer systems for registration, billing, appointment scheduling, and managed care options, and the various managed care plan electronic/on-line authorization technology (NHP NET, NEHENLite, WebMD, Tufts, etc.)
• Excellent customer service and interpersonal skills.
• The ability to work independently in a fast paced environment.
• Ability to communicate with internal and external customers.
• Exceptional organizational skills

Nice To Haves

• Fluency in English & Spanish preferred

Responsibilities

• Maximize reimbursement to the health center from various managed care payors by scheduling specialty appointments appropriately, and communicating the outcome to the patients and/or the specialist’s office
• Establish and maintain professional collaborative relationships with internal and external customers
• Educate/communicate with patients about their insurance so that they schedule specialty appointments within their insurance network and/or understand the financial consequences of seeing providers out of network
• Provide patients with the highest quality of customer service in accordance with NeighborHealth’s mission and vision
• Review and address Epic in-basket messages in a timely manner, taking action within 24-48 hours of receipt. With great attention to detail, schedule all external specialty visits for your assigned Referral workqueue per department guidelines; cover other workqueues as needed. Exhaust all avenues to achieve the goal on securing the appointment within the requested timeframe. Follow up with primary care provider if unable to schedule as order specifies to explore alternatives. Ability to understand and interpret medical terminology in the orders for the purpose of making a relationship between the diagnosis and what accompanying documentation is required, such as recent lab results or other diagnostic test results.
• Process 65 referrals or more a day for BMC work queues
• Process 40 or more referrals a day for non BMC referrals

Benefits

• Medical, dental, and vision coverage.
• Life and disability insurance.
• 401(k) retirement plan.
• Tuition reimbursement.
• Flexible spending and transportation accounts.
• Paid holidays, vacations, sick, and personal time.
• Generous staff development benefit.
• Excellent malpractice coverage.
• Pet insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED