Referral Coordinator - Quincy, MA

Gather Health•Quincy, MA

About The Position

Who we are: Gather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology, Gather Health’s solution drives substantial care outcomes by addressing the whole person needs of our target demographic: older, dual eligible adults, the fastest growing government segment. To address the needs of these clinically and socially complex patients, Gather Health’s Social Primary Care solution is comprehensive and wholistic in nature, encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients. Gather’s model achieves superior care by individualizing care and is reinforced by a three-prong approach: a unique care model quarterbacked by PCPs and supported by multi-disciplinary care teams, tailored Social Care Plans that are led by Gather Guides and facilitated by deeply rooted community partners, and a proprietary “Tech Enabled Home Model.” Founded in 2022 and born out of the Healthcare Foundry Portfolio, Gather Health is addressing a $1 trillion market in primary care for older adults. Today, Gather Health operates in Massachusetts and is working with a multitude of payer partners on aligning value-based care economics to deliver integrated care. Gather’s leadership team has a track record of building and scaling innovative primary care platforms focused on vulnerable populations, including VillageMD and Commonwealth Care Alliance. Gather has raised $30M backed by Maverick Ventures, Khosla, and HC9 Ventures. Summary of Referral Coordination Partner Role: The Referral Coordination Partner will play a vital role in connecting our patients with specialists and other providers outside of Gather Health and ensuring a seamless process. There are many aspects that require coordination that can be confusing to the patients – things such as scheduling a date and time, running insurance verifications, obtaining/sending electronic medical records from/to other clinics/hospitals, etc. – and the Referral Coordination Partner will be the central organizer in all activities related to referrals for our patients.

Requirements

Minimum of one year experience coordinating referrals in a medical clinic
High school diploma or G.E.D.
Minimum of one year experience working with an Electronic Health Record software
Solid understanding of medical terminology
Strong interpersonal skills with experience working in settings requiring frequent communication via phone and in-person
Experience with basic office tools such as email, Outlook calendar, Excel, Slack/Teams, etc.
Strong verbal, written, and reading comprehension skills in English
Proven track record of detail orientation and the ability to multi-task in a busy clinic
Ability to work from 8am to 5pm Monday through Friday
Ability to work from home for part of the time, with appropriate setup conducive to performing work including phone calls
Ability to work for any employer in the United States

Nice To Haves

Experience with CPT and/or ICD coding, or HCPCS
Experience with seniors, under-served populations, individuals with disabilities or other complex social needs
Experience working in a primary care clinic setting
Experience working with Athena

Responsibilities

Schedules and pre-registers patients for exams and procedures with specialists and providers outside of Gather Health and confirms those scheduled appointments with specialists and providers
Notifies patients of appointment information, including, date, time, location, etc.
Communicates with patients with regards to their transportation needs; contacts insurance carriers to verify transportation benefit eligibility, and coordinate accordingly
Ensures patients’ external missed appointments are rescheduled and communicated to the clinical care team
Uses Web resource portals such as Availity and OneSource to generate authorizations
Work through the denials/appeals process with Gather Health providers
Coordinates authorizations and acquisition of Durable Medical Equipment
Participates in daily and weekly clinical care team meetings
Communicates with the clinical care team to ensure patients referral needs are met
Addresses referral-based phone calls and messages in a timely fashion
Retrieves consultation notes, test results, and medical records - submits appropriate clinical documents to specialist offices and uploads documents into electronic medical record platform (Athena)
Provides backup support for front desk duties as necessary
Performs other related duties as assigned