Senior Referrals and Clinical Support Coordinator

Job Description

Job Description

SUMMARY:

NACC’s mission is to promote the health & wellness of mind, body, and spirit of Native American families. We offer a full range of healthcare services that include Medical, Behavioral Health, Dental, and Substance Abuse. The Clinical Support Coordinator provides administrative and operational support to clinical teams to ensure efficient patient care delivery. This role is responsible for processing medication prior authorizations, coordinating and tracking referrals, and performing additional support duties that enhance workflow efficiency, patient access, and care continuity

DUTIES AND RESPONSIBILITIES:

Core duties and responsibilities include the following. Other duties may be assigned.

Medication Prior Authorizations

• Process medication prior authorization requests in a timely and accurate manner.
• Gather and submit required clinical documentation to payers.
• Communicate with providers, pharmacies, insurance companies, and patients regarding authorization status.
• Track authorization outcomes and follow up on pending requests to prevent delays in care.
• Maintain accurate records within the electronic health record (EHR) and other tracking systems.

Referral Coordination & Tracking

• Coordinate outgoing and incoming referrals, ensuring complete and accurate documentation.
• Schedule appointments with specialty providers as needed and communicate details to patients.
• Monitor referral status to achieve closed-loop tracking, including appointment completion and receipt of consultation notes.
• Follow up with external providers to obtain reports and outcomes.
• Identify and escalate barriers to referral completion.

Clinical & Administrative Support

• Provide general administrative support to clinical teams, including documentation assistance and data entry.
• Maintain confidentiality and compliance with all regulatory and organizational policies.
• Participate in process improvement initiatives to enhance efficiency and patient experience.
• Perform other duties as assigned to support clinic operations.

SUPERVISORY RESPONSIBILITIES:

This job has no supervisory responsibilities.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education:

• High school diploma or equivalent required.
• Associate degree or certification in healthcare administration, medical assisting, or related field preferred.

Experience:

• Prior experience in healthcare, care coordination, referrals, or prior authorizations required.
• Experience working with electronic health records required.

Knowledge, Skills, and Abilities:

• Strong organizational and time-management skills with attention to detail.
• Ability to manage multiple tasks and priorities in a fast-paced environment.
• Excellent communication and interpersonal skills.
• Knowledge of medical terminology and insurance processes preferred.
• Proficiency in standard office software and healthcare systems.
• Ability to maintain confidentiality and professionalism at all times.

COMPETENCIES:

Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.

Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.

Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.

Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.

Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.

Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.

Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.

Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.

Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

PHYSICAL DEMANDS AND WORK ENVIORNMENT:

Continually required to sit

Frequently required to utilize hand and finger dexterity

Occasionally required to climb, balance, bend, stoop, kneel or crawl

Frequently required to talk or hear

While performing the duties of this job, the noise level in the work environment is usually quiet-moderate

The employee must occasionally lift and /or move more than 25 pounds, and frequently lift and/or move up to 25 pounds

Specific vision abilities required by this job include Close vision; ability to adjust focus