Referral Coordinator

Referral Coordinator

By working at Harvard University, you join a vibrant community that advances Harvard's world-changing mission in meaningful ways, inspires innovation and collaboration, and builds skills and expertise. We are dedicated to creating a diverse and welcoming environment where everyone can thrive.

Harvard University Health Services (HUHS), part of University Central Administration (CADM), is the on-site multi-specialty medical practice and health administration for the Harvard community. It provides care to students, faculty, staff, eligible post-docs, retirees, and their dependents. HUHS also manages two university-owned health plans, HUGHP and SHIP, and collaborates with other departments to address public health needs.

Serves as liaison between patients and providers to schedule diagnostic tests and specialty consultations at outside organizations (prior authorization as needed) and in-house specialty appointments. Obtains date of service and follows up with visit results. Assists patients with tracking referral status in the electronic system. Works collaboratively with Member Services and Care Coordination departments. Office responsibilities include data entry and coordination of mailings. Collaborates with satellite and specialty offices in processing referrals.

Referral Coordinator Responsibilities

• Knowledgeably articulates insurance limitations to patients.
• Tracks referral status in the electronic system and ensures documentation of referral visits is available for PCP follow-up or upon request.
• Schedules diagnostic tests and specialty consultations at outside organizations.
• Assists patients with scheduling in-house specialty appointments.
• Assists patients by providing directions to outside facilities.
• Communicates with outside referral services by telephone, fax, and e-mail.
• Serves as liaison between patient and inside/outside providers.
• Communicates referral appointment information to patient and provider.
• Keeps pre-testing instructions updated from referral organizations.
• Generate reports as requested.
• Work collaboratively with Member Services and Care Coordination department.
• Enters referral into Blue Cross Provider Central
• Enters patient information into Blue Cross Provider Central to obtain prior approvals.
• Initiates process for over 90 days and out of network referral requests in coordination with Member Services.

General Office Responsibilities

• As a member of the clinical care team, assures the safe and satisfactory care of patients.
• Opens and closes the clinic according to written protocol.
• Schedules patient appointments utilizing all functions of the appointment system.
• Completes all the necessary information in scheduling patient appointments.
• Handles all emergency phone calls appropriately, efficiently, and according to emergency protocol.
• Responds appropriately to patient requests for medical record information.
• Types and sends letters.
• Assists patients by providing directions, escorting, transporting, and ensuring their comfort and safety.
• Sets priorities in organizing activities for the day.
• Demonstrates flexibility when unexpected changes in assignment occur.
• Identifies own learning needs and requests assistance from others when needed.
• Documents care provided using appropriate forms.
• Demonstrates the ability to identify and respond to potential life threatening situations during telephone encounters.
• Demonstrates universal precautions in all care delivery.
• Carries out proper procedure for reporting faulty equipment.
• Prepares medical records ensuring that confidentiality is maintained.

Professional / Team Workplace Accountability

• Maintains patient confidentiality.
• Demonstrates respect in all interpersonal interactions.
• Works collaboratively with all members of the health care team.
• Performs all personal business away from patients and all work areas.
• Identifies own learning needs and requests assistance from others when needed.
• Adheres to regulatory guidelines i.e. AAAHC, DPH, OSHA, etc.
• Adheres to departmental and unit specific policies, procedures, guidelines and protocols.
• Participates in orientation of new staff members.
• Attends staff meetings and educational offerings required by the department.
• Provides coverage to other areas as necessary.
• Performs related duties as required.
• Plans for time off in advance and according to clinic policy.
• Provides proper notification for absences or tardiness.
• Is punctual and prepared for duties at start of shift.
• Is reliable and dependable in coming to work.
• Is flexible and responsive to the needs of the clinic and department in regard to work schedule.
• Demonstrates caring and willingness to help in all interactions.
• Cooperates and complies with goals/projects of clinic and department.
• Utilizes time productively.
• Maintains professional conduct and appearance.
• Performs other duties and responsibilities as needed.

Age-Specific Competencies

• Provides care to the adolescent through utilization of the following:
  • Supplements explanations with reasons for "why?"
  • Encourages questions regarding fears.
  • Allows adolescent to maintain control.
  • Realizes there may be resistance.
  • Provides privacy.
• Provides care to the adult patient through utilization of the following:
  • Recognizes anxiety regarding potential chances in lifestyle resulting from illness.
  • Provides education based on learning needs.
• Provides care to the geriatric patient through utilization of the following:
  • Speaks distinctly due to loss of ability to discriminate sounds.
  • Slows pace of explanation due to slowed cognitive functioning.
  • Maintains a safe environment based upon physical and psychological function.

Compliance

• Adheres to the expectations and professional responsibilities of the department.
• Employs the standards, practices, and procedures of the department.
• Completes and complies with HUHS training requirements including HIPAA Privacy and Security.
• Reports non-compliance incidents to the supervisor, manager, and/or Compliance Officer.

Qualifications

Basic Qualifications:

• High school diploma or equivalent.

Additional Qualifications and Skills:

• Medical secretary/patient service experience.
• Typing and/or computer skills, telephone skills, and multi-lingual.
• Excellent interpersonal, customer service and organizational skills.
• Experience with insurance products and obtaining prior authorization.

Additional Information

Standard Hours/Schedule: 35 hours per week, Monday - Friday

Visa Sponsorship Information: Harvard University is unable to provide visa sponsorship for this position

Pre-Employment Screening: Identity, Criminal

Other Information: This position has a 90-day orientation and review period.

Why join Harvard University Central Administration?

Harvard University's Central Administration (CADM) is a 5,000+ employee organization that supports the university's overall excellence by understanding and serving the needs of its schools, students, faculty, staff, alumni, and surrounding communities. Through dynamic and collaborative partnerships, CADM provides high-quality and efficient services to the schools to help them achieve their goals.

Work Format Details

This position has been determined by school or unit leaders that all duties and responsibilities must be performed at a Harvard or Harvard-designated location. Certain visa types may limit work location. Individuals must meet work location sponsorship requirements prior to employment.

Salary Grade and Ranges

This position is salary grade level 052. Please visit Harvard's Salary Ranges to view the corresponding salary