Company: ChenMed Senior Medical Center
Posted on: November 22, 2021
The Referrals Coordinator is highly visible customer service and
the patient-focused role that works directly with our patient
population and their families, insurance representatives and
outside vendors, physicians, clinicians, and other medical
personnel in a dynamic and professional environment to provide the
highest level of quality healthcare to our members.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Coordinates and processes patient referrals to completion with
precision, detail, and accuracy.
Definition of completion:
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,
Uses Web IVR to generate authorizations (Availity, Careplus,
Healthhelp NIA and any other approved web IVR for authorization
Completes orders with proper documentation on where patient is
scheduled and how patient was notified.
Referrals have been sent to specialist office & confirmed
Prepares and actively participates during physician/clinician daily
huddles utilizing RITS Huddle Portal and huddle guide. Communicates
effectively the physicians/clinicians needs or outstanding items
regarding to patients.
Enters all Inpatient and Outpatient elective procedures in HITS
Ensures patient's external missed appointment are rescheduled and
communicated to the physician/clinician.
Participates in Super Huddle and provides updates on high priority
Addresses referral based phone calls for Primary Care Physicians
Completes and addresses phone messages within 24 hours of call.
Checks out patients based on their assigned physician/clinician.
(Note: If assigned Care Coordinator is unavailable at the time of
check out, a colleague shall assist patient. This process does not
apply to Care Specialist)
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
KNOWLEDGE, SKILLS, AND ABILITIES:
Must be detail-oriented, possess the ability to multi-task, and be
open to cross-functionally training in referrals duties.
The individual in this role must exercise proper phone etiquette
and have the ability to navigate proficiently through computer
Must be team-oriented and work extremely well with patients,
colleagues, physicians, and other personnel in a professional and
Exceptional organizational skills with the ability to effectively
prioritize and timely complete tasks. Knowledge of medical
terminology, CPT, HCPCS, and ICD coding preferred.
EDUCATION AND EXPERIENCE CRITERIA:
High School diploma or equivalent required.
1-3 years of relevant work experience is required. Experience with
Web IVRs and obtaining referrals/authorizations for multiple payers
strongly preferred. Healthcare experience in a clinical setting,
preferably within the Medicare HMO population is a plus.
Flu shot & Covid vaccination is required and/or medical or
Keywords: ChenMed Senior Medical Center, Miami , Referral Coordinator, Other , Miami, Florida
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