REFERRAL CLERK (24035)
About The Position
Laredo Technical Services, Inc. provides staffing services to federal Government agencies all over the world. LTSi connects the right opportunities to the right people. With our experience in placing our Team Members throughout the United States and overseas, we excel at providing experienced, professional personnel for a wide range of Professional and Office Administration as well as Medical Services. Our goal is to provide the highest quality professionals in the industry. LTSi’s culture delivers a strong work ethic while going above and beyond with a sense of urgency. We are an employee-driven company. We strive for excellence every day, which is what sets us apart from all the other government contractors. As a Certified Service-Disabled Veteran Owned Small Business (SDVOSB) Minority Business Enterprise (MBE) that provides a broad range of administrative, project management, and medical staffing support services, we are also honored to be a Member of the Military Spouse Employment Partnership (MSEP), and we encourage military spouses to apply for any of our positions for which they feel they are qualified. JOB TITLE: Referral Clerk GOVERNMENT AGENCY & LOCATION: Naval Medical Center Portsmouth - VA POSITION TIMING: Immediate hire upon completion of all background and security investigations.
Requirements
- Six months experience in a medical office setting
- Typing 50 wpm
- High school diploma
Responsibilities
- Manage all specialty care and Right of First Refusal (ROFR) referrals/consults per current DHA, TRICARE, and MTF policies.
- Ensure referrals are appointed to the MTF/Direct Care System within Access to Care (ATC) standards or referred to the local network.
- Document patient responses in MHS Genesis, Referral Management System (RMS), and Health Artifact and Image Management Solution (HAIMS).
- Notify referring providers when patients request referral cancellations.
- Contact provider offices to confirm if patients were seen and obtain referral results.
- Properly close referrals in MHS Genesis and RMS, and notify the referring provider or Primary Care Manager (PCM).
- Assist with the return of completed consult reports to civilian providers for patients seen under ROFR.
- Process ROFRs within TRICARE Operations Manual guidelines.
- Utilize software applications such as MHS Genesis, DEERS, Message Pool/Center, RMS, HAIMS, and Microsoft Office (Outlook, Word, Excel, Access).
- Conduct the Consult/Legible Report (CLR) process, including researching, processing, uploading to HAIMS, and forwarding to providers/PCMs.
- Notify MTF providers when CLRs are posted and monitor their timeliness.
- Chase (retrieve) delinquent CLRs from network providers.
- Validate CLR receipt and cross-check referral authorizations with adjudicated claims.
- Ensure all network referral CLRs have correct disposition or are properly annotated as non-appointed.
- Track consult updates or status changes and document customer feedback in applicable systems.
- Complete referrals within the MTF and provide guidance to correct errors and advise on referral tracking procedures.
- Generate periodic reports on referral accuracy, closure, and results from network referrals.
- Process referrals from the TRICARE Regional Contractor, accepting or denying per MTF guidelines and SOPs.
- Maintain a customer-focused approach in all referral-related tasks.
- Maintain suspense files for network-deferred referrals and compile data for tracking and reporting.
- Submit monthly workload statistics reports to the COR by the 5th business day of each month, including CLR volumes.
Benefits
- Health, Dental, and Vision insurance
- 401(k) Retirement Plan
- Vacation
- Sick Leave
- Disability & Life Insurance
- 11 Paid Federal Holidays including: New Year’s Day Martin Luther King, Jr. Day Presidents Birthday Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Day Christmas Day
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
1-10 employees
