Referral Clerk

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Full Time Staff Full Time Staff Ravenswood, WV, US

Position Reportsto:
Care Manager Coordinator

FLSA Requirements:
Non-Exempt

Thereferralclerkisresponsiblefor coordinatingallservicereferralsforpatientsat

Coplin

Health Systems. Referrals may be from any department within the organization; primary care, dental, pediatrics and/or behavioral health.

• Maintainsongoingtrackingandappropriatedocumentationonreferrals intheelectronicmedical records system topromote clinical team awareness, ensure continuityofcare and patient safety.
• Ensurescompleteandaccurateregistration,includingpatientdemographicandcurrent 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 .
• Contactsorganizationsandinsurancecompaniestoensurepriorapproval requirementsaremet.
• Assures necessary laboratory testing, imaging,tests, etc. required forthereferralsaredocumented 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,clerkwillalertorderingproviderofoutstandingneedsthroughtheelectronichealthrecord through an Action.
• Assists Medical Records Clerks with scanning and reviewing completed referral consultation documentation,testingandradiologyresultsinthepatient’selectronicrecorduponcompletionof referral.
  
  Assures provider was notified of any urgent abnormal results.
• Keepspatientsinformedoftheirappointmentdates/times.
• Reviewsdetailsandexpectationsaboutthereferralwithpatients.
• Ensuresthatreferralsareaddressedinatimelymanner.
• Assistspatientsinproblemsolvingpotentialissuesrelatedtothehealthcare system,financialor 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.
• Identifiesandutilizesculturalandcommunityresources,establishingandmaintainingrelationships with service providers (e.g.,DME,Home Health,Oxygen companies) and keepinganupdatedlistof 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.
• Providesinputonbestpracticesregardingworkflow.
• Performsotherdutiesasassigned,including updatingthecareteamasnewspecialistsareobtained and assisting front desk and medical records.

• Communication(spokenandwritten)
• Confidentiality(accordingtoHIPAAguidelines)
• Professionalism(with patients,colleagues,andothers)
• 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.

Safety & Health

Employees are expected to follow CHS safety and health policies.

Supervisory Responsibilities

ThisjobhasNO

supervisory responsibilities.

This job operates in a professional office environment. This role routinely…