Referral Specialist I - Foster Care

Access Referral Specialist
The Access Referral Specialist is a vital member of the Access Center team, serving as the primary point of contact for answering all inbound calls, faxes, and emails from our referral partners, the community, and from Gilchrist staff which ensures the highest quality customer service in all referral development and management. This role supports the delivery of exceptional customer service and coordinates referral development and patient access for all Gilchrist service lines, including hospice, palliative care, and geriatric medical services. The Access Referral Specialist works under the supervision of the Access Center Manager, to ensure the delivery of high quality, professional, compassionate services in accordance with the mission and core values of Gilchrist. The Access Referral Specialist is accountable for establishing and maintaining relationships with patients, families, and referral sources responding to all customer requests and concerns; The Access Referral Specialist facilitates the admission and appointment scheduling process for hospice patients, serving as the primary point of contact for referral sources. The Access Referral Specialist works cohesively with all organizational disciplines to facilitate hospice, palliative, and geriatric medical service admissions. The Access Referral Specialist will verify insurance coverage for all patients with Medicare/Medicaid and identify all applicable commercial insurance plans and coordinate with the clinical team for concurrent care review as needed. The Access Referral Specialist will utilize DocuSign to obtain signatures for patient consents and other required documentation as needed. The Access Referral Specialist will assist field staff with uploading documents to the EMR and obtaining consent signatures as requested. The Access Referral Specialist is cross-trained to perform the role of the Bed Coordinator when needed. The Access Referral Specialist will monitor the admission appointments for all Gilchrist entities for completeness, geographic efficiency and nurse schedules. The Access Referral Specialist will assist the Access Center Manager with revising workflows/processes, Epic reporting, and Epic Dashboard and Workqueue management. The Access Referral Specialist will be responsible for participating in mentoring and leadership development classes offered by the organization to enhance and expand their leadership skills. The Access Referral Specialist will manage data, and must be proficient in Windows, Excel, and Word interfaces. The Access Referral Specialist will be proficient in all Gilchrist programs.
Associate's or Bachelor's degree preferred.
Minimum of 3 years' experience with Gilchrist or equivalent experience in a complex health care call center required. Working knowledge of the health care environment and terminology preferred.
Strong phone skills to include excellent verbal and active listening.
Able to manage conflict and resolve concerns from the community.
Knowledge and ability to understand and accurately verify insurance benefits Medicare/Medicaid and all commercial insurance payors required.
Understanding of the Condition of Participation, CHAP and other regulatory requirements for admission to hospice, palliative and geriatric services
Strong computer skills
Demonstrated empathy, genuine concern, and passion for helping customers.
Strong assessment skills to identify the customer's needs, clarify information, research issues, and provide resources and information that best meet assessed needs.
Adept at EPIC and able to make recommendations for build outs to meet needs, run reports, analyze data, and implement process improvement changes to improve quality of services.
Ability to work on site and in emergency weather and other situations required.
Is knowledgeable of and is proficient in all regulatory requirements for our all Gilchrist programs and services
Schedule visits for all inquiry and referral callers for all Gilchrist programs and services
Accurately records referral information for business tracking and management
Follow policies and procedures for admissions management
Conducts impeccable follow through for and with customers including both internal and external customers
Demonstrates impeccable customer service and achieves targets for metrics
Maintain accurate pending referral list and communication
Facilitate processing of admission documents from referral call through transfer to appropriate care team
Document all call information according to standard operating procedures within the Epic record
Communicate prospective patient updates to appropriate referral sources and internal stakeholders for unit placement
Communicate with referral source, DME, pharmacy and other vendors to process all certifications, orders, and required admission information
Coordinates patient services such as scheduling ambulances and home medical equipment needed for a complete and safe admission to service.
Enter prospective and admitted patient demographic information and status updates in the Epic database
Obtain information and accurately complete all documentation, forms and logs for referral calls and admissions processing. All data entered into the Epic system
Works the Epic work queue's as outlined in standard work documents
Helps resolve referral and admissions management issues and complaints through direct communication with referral sources and admissions team. Works on special projects that are important to area/process improvement
Make follow-up calls for referral inquiries within required time
Generates and electronically files appropriate patient-related information for the medical record consistent with company policy and regulatory requirements
Runs Daily Epic Admission and Referral Reports, monitors and maintains the Epic Pending Admission report.
Ability to concentrate and pay close attention to detail when typing, proofreading, and completing assignments and driving.
Normal office environment

I will foster a healing environment.

Treats others with fairness, kindness, and respect for personal dignity and privacy
I will strive for superior performance in every aspect of my work. Meets and/or exceeds customer expectations