Referral Clerk

Referral Clerk The referral clerk is responsible for coordinating all service referrals for patients at Coplin Health Systems. Referrals may be from any department within the organization; primary care, dental, pediatrics and/or behavioral health. Essential Functions & Responsibilities of the Position: Maintains ongoing tracking and appropriate documentation on referrals in the electronic medical records system to promote clinical team awareness, ensure continuity of care and patient safety. Ensures complete and accurate registration, including patient demographic and current insurance information documented within the patient electronic health record. Prepares and assembles necessary patient health and demographic information needed to complete referral ordered by the provider. Contacts organizations and insurance companies to ensure prior approval requirements are met. Assures necessary laboratory testing, imaging, tests, etc. required for the referrals are documented in the patient record and available to be forwarded as required for the respective referrals. If laboratory testing, imaging, or other tests, etc. have not been completed and documented for the referral, clerk will alert ordering provider of outstanding needs through the electronic health record through an Action. Assists Medical Records Clerks with scanning and reviewing completed referral consultation documentation, testing and radiology results in the patient's electronic record upon completion of referral. Assures provider was notified of any urgent abnormal results. Keeps patients informed of their appointment dates/times. Reviews details and expectations about the referral with patients. Ensures that referrals are addressed in a timely manner. Assists patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance). Serves as the system navigator and point of contact for patients, families, and may assume an advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion. Identifies and utilizes cultural and community resources, establishing and maintaining relationships with service providers (e.g., DME, Home Health, Oxygen companies) and keeping an updated list of referral providers and facilities. Notifies co-workers when changes or additions are identified. Assists in ensuring that patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health. Provides input on best practices regarding workflow. Performs other duties as assigned, including updating the care team as new specialists are obtained and assisting front desk and medical records. Job Requirements and Preferred Qualifications: Communication (spoken and written) Confidentiality (according to HIPAA guidelines) Professionalism (with patients, colleagues, and others) Excellent Customer Service Computer Skills Medical Terminology Reasoning Ability Cultural Competence (sensitivity to the mission of CHS) Education (level and type) and Related Work Experience Candidates with an NRCMA and/or LPN are strongly preferred. Candidates with an associate's degree and experience in referral/patient navigation and/or billing/medical records will be considered. Working Conditions: This job operates in a professional office environment. This role routinely uses standard office equipment such as laptop computers and smartphones. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The noise level in the work environment is usually moderate with frequent interruptions. The employee must occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected. Employee may be asked to work or travel to any site within the organization for work purposes. Conditions of Employment: Security and Background Requirements If not previously completed, a background security investigation will be required for all applicants. Appointment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a background security reinvestigation or supplemental investigation may be required at a later time. Applicants are also advised that all information concerning qualifications is subject to investigation. False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action. Department of Homeland Security If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS. Direct Deposit All employees are required to have bi-weekly payments made by direct deposit to a financial institution of their choosing. Other requirements of employment: 60-day probationary period is required. Drug Screening is required. WVCares Clearance EEO Statement: Coplin Health Systems provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability or genetics. In addition to federal law requirements, Coplin Health Systems complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Coplin Health Systems expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Coplin Health Systems' employees to perform their job duties may result in discipline up to and including discharge. Acknowledgement: I acknowledge that I have reviewed this job description, that I understand the requirements of this position, that I am qualified and able to perform the requirements associated with this position, and that the job description may be revised by Coplin Health Systems at any time. Signature - Date Witness Signature - Date