Referral Coordinator & Patient Travel Coordinator

Seldovia Village Tribe IRA•Homer, AK

3d•Onsite

About The Position

This position is responsible for communicating important patient information and needs for both inbound and outbound referrals, tracking and following up on referrals to ensure patients obtain needed services outside and inside the health center practice. This position is responsible for monitoring patient referrals. This position also serves as the primary contact for coordinating medically necessary travel authorization for all SVTHW patients.

Requirements

High School Diploma or equivalent, required
Healthcare Relevant – 2 years' experience, required
Proficiency with Microsoft Office (Word, Excel, PowerPoint) and Outlook.
Skill in working independently and as a team member.
Skill in establishing and maintaining cooperative working relationships with others.
Strong communication skills.
Strong attention to detail and concern for completing tasks correctly and efficiently.
Ability to prioritize responsibilities according to urgency and importance.
Ability to maintain a professional and positive attitude at all times.

Nice To Haves

Associate’s Degree preferred.
Minimum of 1 year of experience in medical field – with experience in service delivery (referrals, claims, insurance, billing, etc).
At least 2-years’ experience with referrals and prior-authorizations.
Referral Coordinator – 1 year of experience.
Experience with Worker’s Compensation.
Proficiency in medical terminology.
Proficiency with scheduling/insurance verification software.
Ability to work with patients who are in distress and problem solve in a calm professional manner.

Responsibilities

Collaborates with manager and other leaders to develop, implement, and update policies and procedures related to Referral Coordinator Department operations.
Request authorization from the referring provider for those with insurance requiring authorization.
Document all authorization correspondence in patient’s medical record.
Obtains all medical records necessary for patient referred appointment.
Maintains contact with patient about referral to office/facility regarding insurance and/or benefit conflicts.
Coordinates the referral process with outside organizations and specialists and notifies patient with referral information.
Connects the patient as needed to a Patient Benefits Coordinator who can assist the patient in overcoming barriers to referral.
Work with patient to alleviate barriers to following up with referrals, including assisting patient in scheduling appointments and making travel arrangements when requested.
Request and manage patient records from external sources as necessary.
Educates and assists patients with the authorization and referral process, referrals for specialty care or treatment, and additional clinical testing.
Track patient referred appointments to completion.
Obtain referral outcome/follow-up documentation and route back to ordering/referring provider to “close the loop” in patient care.
Ensure patient’s follow-up care is complete.
Communicate with all members of the team and specialists’ departments regarding the PRC referral process to ensure proper coordination of care.
Monitor outstanding referrals, sending reminder letters at the appropriate timeframe (per referral policy) and sending cancellation letters once the referral is outdated (“stale”) as well as ensure appropriate communication about outdated referrals are carried out with referring provider.
Obtain prior authorization for Medicaid travel (composing letter of medical necessity, if required), for patients to attend medically necessary appointments at an SVTHW site and/or referring provider office.
All requests must be in accordance with, and reviewed against, regulations governing Alaska State Medicaid Prior Authorization to verify eligibility for travel benefits.
Coordinate within the authorized parameters of the given Medicaid Travel Authorization, to include, but not limited to: air and ground transportation, lodging and meals, for patients and their escorts (if applicable).
Must be able to determine medically necessary travel while ensuring patient appointments, travel arrangements, lodging, transportation and other logistical aspects of the patients’ medical travel are completed (patient is responsible for booking their accommodations once authorization is complete).
Work collaboratively with the Alaska Native Medical Center (ANMC) Travel Management Office to assist, and be a point of contact/conduit for local AI/AN patients to obtain travel documentation for services to be received at an ANMC location.

Benefits

11 Paid Holidays per year.
12 Days of Sick Leave per year.
15 days (3 weeks) of Annual Leave per year (starting accrual, more days with more years of service).
FEHB (Federal Employees Health Benefits) - Health Insurance, a variety of plans to choose from. We pay 100% of employees' monthly health insurance premiums! And we pay 50% of the monthly premiums for your spouse and/or children.
Insurance is effective the first day of the pay period after we receive your enrollment form.
Dental and Vision insurance available on the first of the month following 90 days of employment.
Group life insurance, minimum benefit is $50,000 and up to 2x your annual salary. Maximum of $250K life insurance.
Long term disability insurance.
Employer matching 401K, 5% match, effective January 1 or July 1, following one year of employment.
Wellness Incentive Program, up to $300 per calendar year for full-time employees, or $150 for part-time employees, effective after 90 days of employment. Examples of items that can be reimbursed are walking/running shoes, active wear, exercise equipment, gym membership, CSA food boxes and more!