Referral Clerk

Integrated Management Strategies, LLC•Portsmouth, VA

6d•Onsite

About The Position

Integrated Management Strategies (IMS) is seeking an experienced Referral Clerk to join their healthcare consulting practice. This is a full-time, on-site role in Portsmouth, VA, supporting a government healthcare contract at Naval Medical Center Portsmouth within a Department of Defense (DoD) medical treatment facility. The Referral Clerk will manage patient referral processes, including coordinating specialty care appointments, processing consults, tracking authorizations, and maintaining accurate records. The role requires strict adherence to HIPAA, TRICARE, and DoD regulatory standards to ensure timely and accurate handling of referrals and continuity of care. The ideal candidate will possess strong organizational and communication skills, collaborate effectively with providers, case managers, and external networks, and be able to meet government credentialing, security, and onboarding requirements.

Requirements

Minimum of one (1) year of experience
US Citizen
Basic Life Support (BLS)
High School Degree or GED
Must pass TB Test
Subject to a background/security investigation
Willingness to comply with DHA vaccination requirements.
Pre-employment drug screening
Shall maintain good personal hygiene and present a well-groomed and professional appearance IAW the policy at the place of performance.

Responsibilities

Reviews referrals for administrative completeness and researches covered benefits prior to processing.
Determines patient eligibility for services and arranges and schedules medical appointments for referred care.
Provides general instructions to patients and MTF personnel regarding the referral procedures.
Ensures referral results are returned to the referring provider and to the medical record within required timelines. Assists with follow up, written or verbal, as necessary.
Utilizes the referral tracking data collection tool. Calculates metrics, and compiles monthly reports.
Utilize the MHS GENESIS system to retrieve external medical documentation, termed Clear and Legible Reports (CLRs), and upload the results into the patient’s chart.
Utilize telecommunications technology to collect external documentation for patients within NMC Portsmouth by contacting outside clinical practices to retrieve patient and service documentation.
Communicate with providers regarding CLRs if they are incorrect or need additional context; this communication is likely to come through MHS GENESIS.
Review referral notes, including but not limited to; consultation, operative, and discharge summaries requested when a TRICARE Beneficiary is referred to external providers for care. Return these external documentations to the patient chart.
Chase external notes from network providers for patients to upload into the patient chart for clear reporting of patient encounters through various telecommunication methods including phone, fax, and secure mail.
Respond to provider queries regarding external provider notes and documentation.
Ensure referral results are returned to the referring provider and to the medical record within required timelines. Assist with follow up, written or verbal, as necessary.
Utilize the referral tracking data collection tool within MHS GENESIS and discern reporting system to measure amount of outstanding CLRs.

Benefits

401(k) Retirement Plan
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time
11 Company Paid Holidays
Medical & Dependent Care Flexible Spending Accounts
Group Life & Accidental Death & Dismemberment (AD&D) Insurance
Group Short Term Disability Insurance
Voluntary Life Insurance, Long Term Disability Insurance, Accident Insurance, Critical Illness Insurance, and Hospital Indemnity Insurance
Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Position may be eligible for a discretionary variable incentive bonus