Referral Coordnator

Central Ozarks Medical Center•Camdenton, MO

About The Position

Responsibilities: Ensure complete and accurate referrals, including medical records and current insurance information. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Process patient referrals in a timely and accurate manner and follow up on referral statuses • Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety. This tracking may use an IT database. • Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to nursing staff/providers. • Contact review organizations and insurance companies to ensure prior approval requirements are met. • Present necessary medical information such as history, diagnosis and prognosis. • Provide specific medical information to financial services to maximize reimbursement to COMC. • Review details and expectations about the referral with patients. • Assist patients in problem solving potential issues related to the health care system, financial and social barriers. • Be the system navigator and point of contact for patients and families. • Assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary services in a timely fashion. • Identify and utilize cultural and community resources. • Establish and maintain relationships with identified service providers. • Ensure that referrals are addressed in a timely manner. Qualifications Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This includes moderate physical effort consisting of sitting for prolonged periods of time and occasionally lifting or moving over 35 pounds of weight. Travel Requirement: To fulfill the responsibility of the position travel to all COMC locations will be required. Employee should have valid Missouri driver’s license. Overnight travel may also be required in specific incidences of training, conferences, etc. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Knowledge of, and compliance with, HIPAA and 340B regulations is required. Confidentiality of patient information is mandatory. About COMC: Central Ozarks Medical Center has been providing quality health care in Central Missouri since 1979. Central Ozarks Medical Center’s staff members are committed to leading the way to healthier communities. COMC offers a wide range of services based on the needs of the communities we serve. We pride ourselves on offering high quality healthcare regardless of insurance status. Our Mission COMC is committed to leading the way to healthier communities by reducing barriers to care, ensuring access for all, and creating a positive working environment of engaged team members with a shared goal. Our Values At COMC, we use the following strategically anchored values to guide all our actions: Selfless Service: We lead by example Approachable: We communicate openly Resilient: We enable and Inspire Passionate: We promote community Responsive: We take action Resourceful: We collaborate

Requirements

High school diploma or GED.
Ability to respond to common inquiries or complaints from customers and regulatory agencies.
Ability to effectively communicate.
Knowledge of fundamental math.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Effective verbal and written and communication skills required.
Ability to provide excellent customer service.
Organized and able to manage competing priorities.
Resourcefulness in problem solving and good judgement.
Must be able to work in a fast-paced environment.
Data entry skills required.
DEPENDABILITY AND RELIABILITY: Performs all duties and assignments whether or not supervision is present.
COMMUNICATION SKILLS: Expresses ideas, information, and instruction in a positive and effective manner.
TEAMWORK and COOPERATION: Works cooperatively with coworkers and supervisor. Acts as an effective team member with other employees through cooperation.
JUDGMENT: Makes reasonable and appropriate decisions.
ADAPTABILITY: Readily and effectively adjusts to changing ideas and activities.
ROLE MODELING: Acts as a good role model for other employees.
CREATIVITY: Shows imagination and innovation in solving problems.
ATTENDANCE: Reliably reports for work as scheduled, willing to work OT when needed.
SAFETY: Follows all safety rules and works in a safe manner.
PRODUCTIVITY: Produces an acceptable amount of work, of sufficient quality in an appropriate amount of time.
Employee should have valid Missouri driver’s license.
Knowledge of, and compliance with, HIPAA and 340B regulations is required.
Confidentiality of patient information is mandatory.

Nice To Haves

Medical assistant certification is desirable.

Responsibilities

Process patient referrals in a timely and accurate manner and follow up on referral statuses
Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety. This tracking may use an IT database.
Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to nursing staff/providers.
Contact review organizations and insurance companies to ensure prior approval requirements are met.
Present necessary medical information such as history, diagnosis and prognosis.
Provide specific medical information to financial services to maximize reimbursement to COMC.
Review details and expectations about the referral with patients.
Assist patients in problem solving potential issues related to the health care system, financial and social barriers.
Be the system navigator and point of contact for patients and families.
Assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary services in a timely fashion.
Identify and utilize cultural and community resources.
Establish and maintain relationships with identified service providers.
Ensure that referrals are addressed in a timely manner.