Referral/Refill Clerk

Job Summary: The person in this position is part of the team concept in the Center’s health delivery system, which is devoted to coordinating all patient referrals at the request of the providers. Responsible for coordinating referrals with patients as well as tracking any reports as they are received. Responsible to ensure patients will receive timely, high quality and efficient specialty care and support services through the referral system. Must be familiar with community resources to facilitate the needed services for patients at Omni Family Health.

Job Duties:

1. The Referral Clerk will efficiently coordinate all patients’ referrals at the request of the providers.
2. Supports patient health by appropriately schedule and/or cancel all appointments, coordinating with the patients and the outside providers.
3. Appropriately determines and validate patient eligibility, validate patient demographic information and pull records and file documentation.
4. Will efficiently notify the patient of said appointment and give any instructions if needed.
5. Advocate for patient discounts with local vendors, including hospitals, laboratories and individual medical providers especially for sliding fee scale and self pay patients.
6. Prepare authorizations necessary for outside patient care, and health plan payment.
7. Expected to proficiently track and record reports in the referral systems and electronic health record as they are received.
8. Follow-up on pending referrals to include sending certified letters to non-compliant patients.
9. Cooperatively work with outside agencies to help patients apply for alternate resources when appropriate.
10. Other related duties or responsibilities as assigned.
11. Promote and believe in OFH mission statement.
12. Ability to relate to the public regardless of racial, ethnic and economic status.

Additional Duties:

1. HIPAA compliance - Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements. Treats all member information confidential.
2. Compliance - Ensure compliance with all local, state and federal regulations.
3. QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
4. IT - Required to learn and use the Electronic Health Record and Practice Electronic System and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
5. All employees will participate in Patient Centered Health Home Model at Omni Family Health.

Qualifications, Education, and Experience:

1. Must have thorough education or training in the basics of medical terminology and/or medical administration. Past work experience in the medical field will be considered in lieu of education or training in the basics of medical administration.
2. High school diploma or equivalent.
3. Referral experience preferred.
4. Bilingual in English/Spanish preferred.
5. Ability to work with clinical staff and handle pressure from more than one provider.
6. Ability to work with frequent interruptions and manage multiple priorities.
7. Commitment to the concepts of preventive health care program and team approach to health care delivery.

Responsible To: Referral Supervisor

Classification: Non-Exempt