Referral Clerk

Coplin Health Systems•Ravenswood, WV

5d•Onsite

About The Position

The referral clerk is responsible for coordinating all service referrals for patients at Coplin Health Systems. Referrals may be from any department within the organization; primary care, dental, pediatrics and/or behavioral health.

Requirements

Communication (spoken and written)
Confidentiality (according to HIPAA guidelines)
Professionalism (with patients, colleagues, and others)
Excellent Customer Service
Computer Skills
Medical Terminology
Reasoning Ability
Cultural Competence (sensitivity to the mission of CHS)

Nice To Haves

NRCMA
LPN
associate’s degree and experience in referral/patient navigation and/or billing/medical records

Responsibilities

Maintains ongoing tracking and appropriate documentation on referrals in the electronic medical records system to promote clinical team awareness, ensure continuity of care and patient safety.
Ensures complete and accurate registration, including patient demographic and current insurance information documented within the patient electronic health record.
Prepares and assembles necessary patient health and demographic information needed to complete referral ordered by the provider.
Contacts organizations and insurance companies to ensure prior approval requirements are met.
Assures necessary laboratory testing, imaging, tests, etc. required for the referrals are documented in the patient record and available to be forwarded as required for the respective referrals. If laboratory testing, imaging, or other tests, etc. have not been completed and documented for the referral, clerk will alert ordering provider of outstanding needs through the electronic health record through an Action.
Assists Medical Records Clerks with scanning and reviewing completed referral consultation documentation, testing and radiology results in the patient’s electronic record upon completion of referral. Assures provider was notified of any urgent abnormal results.
Keeps patients informed of their appointment dates/times.
Reviews details and expectations about the referral with patients.
Ensures that referrals are addressed in a timely manner.
Assists patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
Serves as the system navigator and point of contact for patients, families, and may assume an advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
Identifies and utilizes cultural and community resources, establishing and maintaining relationships with service providers (e.g., DME, Home Health, Oxygen companies) and keeping an updated list of referral providers and facilities. Notifies co-workers when changes or additions are identified.
Assists in ensuring that patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
Provides input on best practices regarding workflow.
Performs other duties as assigned, including updating the care team as new specialists are obtained and assisting front desk and medical records.