Referral Management Coordinator - Worker's Compensation

Concentra•Plano, TX

About The Position

Do you want to use your problem solving skills and knowledge of customer service to help improve the health of America's workforce? At Concentra, we serve more than 500 medical centers and 130 onsite clinics nationwide. Concentra colleagues remain fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner. We do this by putting all customers first. The Referral Management Coordinator maintains high standards for quality and an exceptional patient experience in accordance with Concentra’s policies, procedures and applicable regulations. The Referral Management Coordinator processes referrals requests and authorizations while working closely with physicians, employers and payors. Customer services is a top priority in order to achieve a positive impact on the cost and quality of care rendered to injured employees. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Requirements

High school diploma or GED equivalent
Must be a current Texas Resident
Must remain a Texas Resident during the duration of employement within the Referral Department
Must be able and willing to travel to a local Concentra to complete new hire orientation
Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)
Proficiency with scheduling/insurance verification software
Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
Familiarity with Microsoft Excel, Outlook, Word
Excellent communication skills and ability to communicate (both written and orally) effectively with colleagues at all levels of the organization
Must display proper business etiquette and be skilled in the arts of diplomacy and tact
Excellent time management skills including the ability to multitask and prioritize in a fast-paced environment
Ability to build and maintain productive business relationships
Exemplary ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
Excellent writing and documentation skills
Strong attention to detail
Ability to work independently
Ability to handle special projects
Ability to handle multiple tasks, projects, duties, and priorities, when assigned

Nice To Haves

Associated Degree from an accredited college preferred
Experience with Worker's Compensation preferred

Responsibilities

First point of escalation for all case related issues requiring guidance
Responsible for daily completion of assigned patient referrals, while meeting production requirements
Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market
Obtains authorization for Specialist referrals and schedules appointments accordingly
Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable
Provides all necessary information such as medical records, prescriptions, etc. to payor
Communicates with stakeholders, payor, employer, and patient as appropriate
Records all appropriate information via OA/CR module of OccuSource per Concentra policy
Builds relationships with provider, employer and payor communities
Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor
Handles calls according to the call guidelines of the department
Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions