Lead Referral Coordinator

Lead Referral Coordinator

Lead Referral Coordinator

Department: Patient Services

Location: Rancho Cordova Health Center

Reports to:  Patient Services Manager

Status: Full-time

FLSA: Non –Exempt

Pay Range: $24.90 - $32.37/hr
EEO-1:  Service Worker

 

Organization Information

 

WellSpace Health believes that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. We see you and are here for you. To that end, we have committed ourselves to finding solutions for our community’s health and wellbeing to achieve regional health through high quality comprehensive care.

 

Our focus has always been to offer a full range of quality medical care, dental care, mental health and behavioral health services, and enabling services to underserved people.  We do this by placing ourselves within the communities we serve and employing outstanding healthcare professionals who are devoted to our mission.

 

We are a Federally Qualified Health Center (FQHC) and are accredited by the Joint Commission for Ambulatory Care and Behavioral Health. We are also certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home.

 

Position Summary

 

Under the direction of the Patient Services Manager, the Lead Referral Coordinator provides expertise and guidance to a team of referral coordinators in organizing the day to day referral process, ensuring the appropriate use of standards. The Lead Referral Coordinator monitors compliance with policies and procedures to assure the goals and objectives for the appropriate and timely processing of internal and specialty referrals are met.

 

Required Qualifications

 

• High School Diploma or equivalent.
• Medical Assistant training/certification preferred.
• At least two years’ experience in medical referrals.

• Excellent communication skills (oral and written) including the ability to communicate effectively with employees, patients and providers over the phone, in email, and other communications.  
• Strong customer service experience including active listening, problem solving, and the ability to remain calm in emotional or stressful situations.
• Ability to maintain detailed records.
• Ability to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline.
• Ability to use standard office equipment including phone, fax, computer.
• Proficient in Microsoft Office, NextGen and EPIC electronic health record system (EHR) preferred.
• Thorough understanding of medical terminology, payer sources, insurance and program requirements.
• Ability to maintain patient confidentiality and adhere to HIPAA regulations.
• Ability to work flexible schedule when needed.
• Demonstrated ability to effectively problem solve and knowledge of leadership practices and principles, including work planning, scheduling, reviewing and training.
• Attention to details and ability to work independently and as a team player.
• Able to take and follow through with delegated tasks and accountability.
• Demonstrated commitment to the provision of care services for the underserved.
• Demonstrated ability and sensitivity working with a variety of people from low-income populations, with diverse educational, lifestyle, ethnic, and cultural origins.
• Adherence to infection control procedures, including but not limited to, standard precautions of temperature monitoring, hand washing, symptom self-monitoring, masking and social distancing.
• Assist and support the Center/Department/Program to meet standards of High Reliability.

 

Essential Responsibilities

 

• Plans, organizes, directs and coordinates the operations of the referrals team.
• Provides oversight of daily operations for the department including metrics, performance and reporting.
• Leads regularly scheduled team meetings.
• Maintains ongoing tracking and appropriate documentation on referrals to promote team awareness and ensures patient safety using the EHR system.
• Assists staff to handle work volume and issues, in accordance with the organization policies and procedures.
• Mentors, directs and trains staff to ensure that work is carried out in a structured manner.
• Coordinates the upkeep of the referral tracking systems used.
• Proficiently tracks and records reports in the EHR.
• Reviews details and expectations about the referral with patient, and is point of contact for patients on referral submission progress and updates.
• The Lead Referral Coordinator may also schedule referral appointments directly on behalf of the patient.
• Answers inquiries from clinical teams and patients, provides information, and resolves complaints from the public or other agencies in regards to referrals.
• Ensures that referrals are processed in a timely manner.
• Reviews status on Treatment Authorization Request (TARs) and any other authorizations, requirements of Managed Care Organizations to assure compliance with health plan programs.
• Follows-up on pending referrals, reviews, and manages the tracking system.
• Responsible for referral report management and reporting to management.
• In coordination with the Referral Supervisor audits information entered in the EHR to ensure compliance with capturing necessary data as required by reporting agencies patients.
• Investigates difficult cases; primary contact for patient’s or provider’s inquiries/concerns in obtaining appropriate care for the patient.
• Utilizes EHR functions to document all pertinent information.
• Assists with daily scheduling for referral volumes and adherence to patient and /or client/organization overall service level agreements (SLA).
• Ensures all tasks, emails, correspondences, research functions are handled in conjunction with SLA and compliance standards.
• Identifies trends and escalates issues to manager timely to minimize the organization risk, enhances the patient/client experience, and adherences to root cause policies and procedures.
• Performs other related duties as assigned or requested.

 

Benefits

 

Successful candidate will receive regionally competitive salary, above average health benefits at reduced costs, company paid life insurance & long-term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement.

 

• Paid bereavement and jury duty leave
• 11 paid holidays per year
• Paid time off
• Paid sick leave
• Flexible Spending Program
• Company paid malpractice insurance for all providers
• Professional development hours offered annually

 

Physical Demands and Work Environment

 

The work environment is characteristic of a medical clinic environment.  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. While performing the duties of this job, the employee is frequently required to sit; use hands to handle, or feel.  The employee is also required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus.   The employee must also possess hearing and speech to communicate in person and over the phone.  The noise level in the work environment is usually quiet.

 

The employee may be in contact with individuals and families in crisis who may be ill, using substances and/or not attentive to personal health and safety for themselves or their homes. The employee may experience a number of unpleasant sensory demands associated with the client’s use of alcohol and drugs, and the lack of personal care.  The employee may also be exposed to bodily fluids (blood, urine) and hazardous chemicals.

 

WellSpace Health is committed to the principals of equal employment.  We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations.  It is the intent of WellSpace Health to maintain a work environment free of harassment, discrimination, or retaliation because of age, race, religious creed, color, national origin, ancestry, physical disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding and/or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by federal, state or local laws.  WellSpace Health is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment.

 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WellSpace Health is an Equal Opportunity Employer

Qualifications

Salary : $25 - $32