Referral Coordinator / Patient Care Navigator

Job Description

Job Description

Benefits:

• Free uniforms
• Paid time off
• Bonus based on performance

SUMMARY

The Referral Coordinator is responsible for coordinating care transitions when patients are referred for specialty care not provided by Apex Community Health Center (ACHC). The Referral Coordinator ensures all referrals are tracked, followed up, and closed in accordance with ACHCs Referral Tracking and Follow-Up Policy. This includes verifying that patients attended specialist appointments and that consult reports are received, reviewed, and filed to ensure continuity of care (closing the loop). Apex Community Health Center also requires the Referral Coordinator to participate in trainings and quality improvement activities.

ESSENTIAL DUTIES

Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety and satisfaction.

Ensure complete and accurate registration, including verification of demographics and current insurance information.

Assemble information concerning the patients clinical background and referral needs.

Contact review organizations and insurance companies to ensure prior approval requirements are met.

Review details and expectations about the referral with patients.

Assist patients in problem-solving potential issues related to the health care system, problems with insurance coverage, or social barriers such as interpretation or transportation needs.

Identify and utilize community and cultural resources suited to patient populations.

Track all referrals in ECW (EClinicalWorks) and referral tracking log from initiation to closure, ensuring timely follow-up and documentation.

Monitor referral timelines and ensure completion based on urgency (urgent: 2472 hours; routine: 72 hours2 weeks).

Follow referral closure protocol: verify that patients completed the referral visit, confirm Apex received consult reports, and document outcomes in ECW and tracking log.

If consult reports are not received within three weeks of appointment, follow up with the specialists office and document contact attempts.

Close referrals within 30 days of appointment or after three unsuccessful contact attempts (two phone calls and one letter).

Immediately notify the ordering provider of any critical or time-sensitive findings received from specialists (same day or within 24 hours).

Ensure consult reports are reviewed by providers, scanned into the patients EHR, and that care plans are updated accordingly.

Ensure referrals are addressed in a timely manner.

Participate in initial and annual compliance and referral tracking training per HRSA/PCMH standards.

Assist in preparing referral data and reports for Quality Improvement Committee quarterly review.

Cross-train as a back-up in the dispensary in case the pharmacy technician is absent.

Must demonstrate integrity, sound judgment, leadership skills, and strong interpersonal skills.

Other duties as assigned.

QUALIFICATIONS

Ability and willingness to work with people regardless of age, race, ethnicity, gender, sexual orientation, or disease state.

Ability to maintain a friendly attitude with patients and staff, especially under pressure.

Able to manage multiple priorities.

Ability to speak, understand, write, and type English as well as have basic math and spelling skills.

Manual dexterity.

EDUCATION/EXPERIENCE

High School Graduate/GED.

Minimum 1-2 years of progressive experience in referral coordination in a healthcare facility, preferably with a federally funded health center doing business in California.

Current CPR certification or certification within 3 months of initial hire.

LANGUAGE SKILLS

Must be fluent in either Armenian OR Spanish.