Referral Specialist

Community Action Partne•Gering, NE

2d•$15 - $18•Onsite

About The Position

Community Action Partnerships of Western Nebraska (CAPWN) is seeking a Referral Specialist to manage external and internal referrals for clinic patients. This role involves scheduling, follow-up, documentation in the Electronic Medical Record (EMR), and collaboration with clinical staff to ensure appropriate scheduling and preauthorization. The Referral Specialist will also work with Patient-Centered Medical Home and Federal Tort Claim Act requirements to ensure patient safety. The organization is a non-profit community-based health and human services organization established in 1965, serving low-income and disadvantaged individuals and families across Western Nebraska.

Requirements

Strong customer service skills
Ability to work alone and unsupervised
Two years of experience in a health care clinic, referral processing preferred
Working knowledge of HIPAA Privacy Regulations, maintaining confidentiality in the provision of all services including written and/or oral reports
Proficient level of oral and written communications with proven skills in grammar, punctuation, style, and editing
Working knowledge of Microsoft Office and Adobe programs
Organized and able to manage competing priorities
Completion of coding course or equivalent (for Grade 2)
Three years of experience in health care setting (for Grade 2)
Associate’s Degree OR Five years of experience in a healthcare clinic setting (for Grade 3)

Nice To Haves

Successful completion of Medical Terminology course or equivalent

Responsibilities

Play an active role in patient care using the provider led, Team-Based, Patient-Centered Medical Home Care Model.
Assemble information concerning patient’s clinical history and referral needs.
Provide appropriate clinical information to specialists and exchange information with outside entities to verify prior authorizations for procedures.
Ensure referrals are addressed in a timely manner including sending referrals, scheduling, follow-up, and requesting and receiving records, completing referrals in the patient’s EMR.
Maintain ongoing tracking and appropriate documentation on referrals to ensure patient safety.
Complete Preauthorization of procedures with insurance companies.
Follow-up with the patient or external agencies per CAPWN Referral Tracking policy and procedures.
Review details and expectations about the referral with patients, including financial assistance programs that are available at the referral site.
Assist in training ordering providers and support staff.
Become knowledgeable of community and CAPWN resources.
Identify and utilize cultural and community resources.
Establish and maintain relationships with identified service providers.
Ensure that a patient’s primary care chart is up to date with information on specialist consultations, hospitalizations, ER visits and community organization related to their health.
Attend staff training sessions and meetings as required.
Maintain confidentiality of records and communications following CAPWN policy and HIPAA privacy and security policies and procedures.
Maintain a positive and professional attitude, striving to openly communicate with co-workers and patients, breaking down communication barriers when necessary.
Dedicate energy to providing high quality, value-added customer service and care to clients.
Engage with the team and commit to improving and nurturing the health and well-being of the Western Nebraska Communities served.
Perform other duties as assigned.