Referral Coordinator

SUMMARY

As a member of the Morongo Basin Healthcare District (MBHD) team your mission is to improve the health and wellness of the communities we serve. You are expected to demonstrate the values of Commitment, Collaboration, Accountability, Dignity, and Integrity in all aspects of your employment. You are responsible for your safety and the safety of patients, visitors and coworkers. You will be required to interact with patients, the public, co-workers and management in fulfilling your mission.
In your role as Referral Coordinator you will report to the EMR Quality Manager. Your responsibilities will include processing prior authorization and referral requests, working with Medical Assistants and Providers to ensure appropriate documentation is present for efficient processing of referrals. You will ensure that referral sources are responded to in a timely manner. Perform follow up on referrals until completion.

DUTIES
Initiate processing of all assigned routine referrals within 24 hours. Urgent/stat referrals will be initiated within 4 hours. If additional information is required, will message the provider.
Proactively searches for relevant and required supporting documentation according to protocols, policies and procedures
Answer telephone calls from specialty providers requesting additional or duplicate supporting documentation
Update referral using structured data fields and notes to document each time the referral is touched.
Respond to denied claims which require supporting documentation for resubmission such as EKG, X-rays, Labs, clinical and/or medication lists same day
Maintain effective communication with patients, communicating status updates timely. Provide updates as needed to Medical Assistants, Providers, and management
Assist patients in scheduling of referral appointments as needed.
Fax supporting documentation to appropriate departments and Specialists office upon request.
Work in conjunction with clinic staff and the provider when necessary to ensure efficient and expedient processing of referrals
Follow up on initiated referrals every 4 days to maintain status and ensure timely care
Update IEHP spreadsheet daily with status changes
Daily calls to patients to inform/schedule and after two calls are documented, send out letter to notify patient
Close open referrals when the patient is non-responsive following letter.
Other duties as assigned.

PHYSICAL DEMANDS
The physical demands described below are representative of those that must be met by you to successfully perform the essential functions of this job with or without a reasonable accommodation. You are required to notify management of any limitations or restrictions that may alter your ability to perform the essentials of the position you hold. You may be required to occasionally lift and/or move up to 20 pounds. You will be required to travel within the service area. You will regularly sit for long periods of time; spend extended time at a keyboard or telephone; and interface with others effectively. You will be occasionally required to stand; walk; and stoop, kneel, crouch, or crawl.

EDUCATION AND EXPERIENCE REQUIRED
High School Diploma or equivalent
Bachelors preferred
A minimum of three years Medical Assistant, Referrals or other appropriate experience required
Medical terminology knowledge required
Good oral and written communication skills