Referral Management Clerk On Site - Misawa, Japan

Arcetyp LLC•Seattle, WA

3d•Onsite

About The Position

Arcetyp LLC is seeking a Referral Management Clerk to work onsite in Misawa, Japan. This role involves managing referrals, coordinating patient care, and acting as a liaison between beneficiaries, healthcare providers, and insurance systems. The position requires adherence to strict medical and governmental regulations, including HIPAA, and involves extensive use of electronic health records and other automated systems. The ideal candidate will be fluent in both Japanese and English and possess strong organizational and communication skills.

Requirements

High School diploma or General Educational Development (GED) equivalency.
Must be able to speak/understand Japanese fluently. If their first language is not Japanese, Japanese-Language Proficiency Test (JLPT) N1 level is required, and certificate must be submitted to the MTF for their review.
Must be able to speak/understand English fluently. If their first language is not English, one of the following tests scores/or higher is required and certificate must be submitted to the MTF for their review: TOEIC 550, TOEFL (PBT) 460, HT941022D0002, TOEFL (CBT) 140, TOEFL (iBT) 50, CASEC 560 (), EIKEN 2nd. If the CASEC score is provided, the contractor personnel is required to complete one of other tests within 6 months. CASEC is considered as only reference score.
Knowledgeable in general medical ethics, health records administration, telephone etiquette, office management methods, excellent communications and customer service skills, strong organizational background and computer operations to include Windows Operating Systems, spreadsheet, database, and word processing applications.
Must submit two references from peers who have had experience with the applicant's practice within the past two years that attest to the HCW's competence to perform the requested privileges.
HCWs shall be in good standing and under no sanction or suspension by the Federal Government.
U.S Citizenship.

Nice To Haves

Basic medical terminology desired.
A thorough understanding of the military lifestyle and experience working with military family members.
Working knowledge of relevant military, state, federal, and local laws and resources.
Highly developed written, oral, and presentation communication skills.

Responsibilities

Comply with the standards of The Joint Commission, applicable provisions of law, and the rules and regulations of any and all governmental authorities pertaining to licensure and regulation of health care personnel and medical treatment facilities, the regulations and standards of medical practice and the MTF’s medical staff bylaws.
Adhere to and comply with the Department of the Navy, and local instructions and notices in effect during the term of the contract.
Participate in peer review and performance improvement activities.
Function with an awareness and application of safety procedures.
Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events.
Anticipate potential problems/emergencies and make appropriate interventions.
Notify director or other designated person regarding problems that the HCW is unable to manage.
Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a reduced risk manner.
Participate in the implementation of the Family Advocacy Program as directed by them government. Participation shall include, but not be limited to, appropriate medical examination, documentation, and reporting.
Exercise awareness and sensitivity to patient/significant others' rights, as identified within the MTF.
Attend and/or comply with all annual training classes required by the Command, to include but not limited to online annual training provided by the MTF, disaster training, infection control, Sexual Harassment, Bloodborne Pathogens, Fire and Safety, Chemical, Biological, Radiological, Nuclear and Explosives (CBRNE), and all other required training.
Actively participate in the command’s Performance Improvement Program.
Participate in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.
Assist in the provision of in-service training to clinic staff members as directed by the Government.
Attend and participate in various meetings as directed by the Government.
Operate and manipulate automated systems such as CHCS, AHLTA, ADS, Essentris, and Clinical Information System (CIS), participate in clinical staff Performance Improvement (PI) and Risk Management (RM) functions, as prescribed by the Commander.
Maintain documentation of all treatment provided in accordance with clinic directives and prepare such records and reports as may be required. Abbreviations must be only those listed in local instructions.
Comply with the HIPAA (Health Insurance Portability and Accountability Act) privacy and security policies of the treatment facility.
Obtain/maintain a National Provider Identifier (NPI) in accordance with DOD and MTF policy/instruction, as applicable.
Assist with the oversight of payment issues, which include the DoD Supplemental Health Care Program.
Acts as an advocate for matters of payment between all TRICARE Beneficiaries and Non-Beneficiaries (Non-TRICARE Insurance holders) and Japanese health care system.
Serves as the focal point between patients admitted off base and coordinates with the Near Patient Team and MTF Case Manager for all matters relating to the patient stay.
Receives, researches, and solves patient concerns on TRICARE issues and benefits.
Coordinates and schedules referrals, transfers, and/or patient movements (aeromedical evacuation) that require special attention, to and from the Japanese organizations through resolution of any medically related situations including decedent affairs.
Coordinates with US personnel and Host-Nation medical facilities in remote areas for assistance, resolution, and processing of any medically related situation.
Use electronic health record to process in house referrals to appropriate clinic.
Upload medical documents to MTF Portal in order for Tricare to translate the report.
Retrieve translated reports from MTF Portal and upload to appropriate patients electronic health record.
Close referrals in Genesis when complete or cancelled.
Notify provider when referral is closed with the details explaining why.
Coordinate patients in queue with rotating provider, create their schedule in Genesis.