Referral Coordinator

ChenMed•Town of Hudson, WI

1d•Onsite

About The Position

The Care Coordinator is a highly visible customer service and patient-focused role. The incumbent in this role works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel to ensure the referral process runs smoothly. He/She operates in a dynamic and professional environment to ensure the highest level of quality healthcare is delivered to our members. ChenMed is a family-owned, family-oriented organization committed to bringing superior health care to moderate-to-low-income seniors. Our vision is to positively change American healthcare through primary care innovation for the neediest populations. Our mission is to provide a convenient, patient-centered environment that fosters enduring relationships between doctors, staff and patients and delivers superior outcomes and a compassionate experience. We will create a healthcare system specifically for our patients' needs through dedicated doctors, a supportive team, and customized technology, and achieve value through scalable innovation, resourcefulness and accountability. Our patient promise is that patients are the reason we are here. Your coordinated healthcare and well-being is our focus. Like a member of our family, we will take care of you in good times and in times of need.

Requirements

Knowledge of medical terminology, CPT, HCPCS and ICD coding desired
Detail-oriented with the ability to multi-task.
Must be open to cross-functionally training in referrals and back office duties
Able to exercise proper phone etiquette with the ability to navigate proficiently through computer software systems
Team-oriented with the ability to work extremely well with patients, colleagues, physicians and other personnel in a professional and courteous manner
Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software
Ability and willingness to travel locally within the market up to 10% of the time
Spoken and written fluency in English

Nice To Haves

Bilingual a plus

Responsibilities

Coordinates and processes patient referrals to completion with precision, detail and accuracy.
Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
Orders have been approved (when needed).
Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
Completes orders with proper documentation on where patient is scheduled and how patient was notified.
Referrals have been sent to specialist office & confirmed receipt.
Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide.
Effectively communicates the physicians/clinicians needs or outstanding items regarding to patients.
Enters all Inpatient and Outpatient elective procedures in HITS tool.
Ensures patient's external missed appointment are rescheduled and communicated to the physician/clinician.
Participates in Super Huddle and provides updates on high priority patients referrals.
Addresses referral based phone calls for Primary Care Physicians panel.
Completes and addresses phone messages within 24 hours of call.
Checks out patients based on their assigned physician/clinician.
Retrieves consultation notes from the consult tracking tool.
Follows up on all Home Health and DME orders to ensure patient receives services ordered.
Provide extraordinary customer service to all internal and external customers (including patients and other ChenMed Medical team members) at all times.
Utilization of patient messaging tools.
Performs other related duties as assigned.