Referral Specialist/CHW

Referral Specialist/CHWUnder general supervision, is responsible for representing Roosevelt General Hospital (RGH) as an exemplary hospital/clinic in the region. The Referral Specialist/CHW will be the embodiment of the hospital's mission, vision and values. They will greet patients, families and hospital guests upon arrival and assist them in navigating through all aspects of their hospital visit. The position is responsible for coordinating any additional care the patient may need inside and outside of our facility. The position is responsible for obtaining prior authorization needed for testing or services.Essential Job ResponsibilitiesPromote the mission, vision, and values of the organizationGreet all patients, families and hospital visitors with a positive, cheerful attitudeNotifies the client of appointments scheduled, makes follow-up calls to off-site providers to ensure that client kept appointment and reminds provider to submit a Consultation ReportMaintains competency in obtaining and inputting medical information to and from clinical and /or other information systems including accessing information as required to complete the referral processScreen and schedule incoming referralsObtain prior authorization for diagnostic services and proceduresWork with Clinician to assess and address patient's needsAssist patients in obtaining medications through prescription assistant programs and other meansCollect data and write brief reports to meet evaluation needs to the ECHO programObtain prior authorization for specialty medications, and coordinate with specialty pharmacyAnswers questions from patients, clerical staff, and insurance companiesEstablish and maintain relationships with identified server providersUtilizes software to code ICD- and CPT codesContact customers to obtain or relay account informationProvides back up support to medical records and front desk registrationBe knowledgeable on all of RGH servicesServe as the main communications person for the department, answering and placing phone calls, taking and relaying messages for clinical staffNon-Essential FunctionsPerforms other duties as assigned.Roosevelt General Hospital (RGH) is committed to providing safe, quality care to patients. Employees are required to adhere to the Values of RGH.Integrity: We conduct ourselves in an ethical and responsible manner. We handle each encounter, whether with patients, families or co-workers, with transparency, respect and honesty. Our actions are aligned with our values.Learning: We believe that growth is enhanced by knowledge and skills. Creating knowledge and skills through teaching and learning is important to us and the healthcare industry. We recognize that learning continues throughout our lives and see learning as essential to keep staff competent. We know that learning changes minds and lives to better serve our patients.Innovation: We continuously seek cutting edge equipment, techniques and training to stay at the forefront of health care. We believe being a rural health care facility does not limit our ability to provide world class, innovative health care.Kindness: We believe in treating others as we would want to be treated. We want to serve each person with genuine compassion, understanding, and kindness, as if they are members of our own family. This sometimes means extending extra grace to others when they don't treat us the same.Excellence: We strive to be the model facility of quality and safety for our patients and staff alike. We hold each other accountable to the highest standards. We want to be the best at what we do.Unity: We stand united in our efforts to provide the best care possible for our patients. We recognize healthcare is no longer dependent on a single provider but is a team sport in which all members play an important role. We support each other and respect the unique skills each person possesses. We also stand in unity with our community and commit to collaborative partnerships for the good of all.QualificationsHigh school graduate or equivalentAbility to communicate effectivelyKnowledge of medical procedures and medical terminologyBasic to intermediate computer knowledgeOne year of medical office experience requiredTyping speed: minimum 40 wpm, computer knowledgeSpanish speaking is preferredPrevious customer service experience preferredKnowledge of CPT / ICD- coding helpful.Professional RequirementsAdhere to dress code, appearance is neat and clean.Complete annual education requirements.Maintain patient confidentiality at all times.Report to work on time and as scheduled.Wear identification while on duty.Maintain regulatory requirements, including all state, federal and local regulations.Represent the organization in a positive and professional manner at all times.Comply with all organizational policies and standards regarding ethical business practices.Communicate the mission, ethics and goals of the organization.Participate in performance improvement and continuous quality improvement activities.Attend regular staff meetings and in-services.Knowledge, Skills, and AbilitiesKnowledge of medical insurances (Medicare, HMO's, PPO's, commercial), EMTALA regulations, hospital billing and collection processMust have an enthusiastic and positive attitudePossess a genuine desire to help RGH become an exemplary hospital in the surrounding community and the stateAbility to work independently, exercise creativity, be attentive to detail, and maintain a positive attitudeAbility to manage multiple and simultaneous responsibilities and to prioritize duties/tasksAbility to initiate communication with patients, their families and hospital visitorsMust have excellent customer service and communication skills with the ability to effectively calm patients and be able to deal with distressed and/or agitated patients and their familiesMust have a professional demeanor and excellent public relations skillsWillingness to develop or improve public speaking skillsMust have excellent written skills with knowledge of medical terminologyMust be dependable and on timePossess good 'people skills' for building relationships with colleagues at all levelsAbility to plan and prioritize workload to meet deadlinesPhysical Requirements and Environmental ConditionsWork is performed during regular work hours, but may require overtime and/or weekend hours to meet deadlinesWork in varying degrees of temperature (heated or air conditioned)Work under extreme pressuresPosition requires sitting for approximately 4-8 hours per day and walking for 2 hours per dayPosition requires light to moderate work with 50 pounds maximum weight to lift and carryPosition requires reaching, bending, stooping, and handling objects with hands and/or fingers, talking and/or hearing, and seeing