Job Description
Job Description
SUMMARY:
Managing, tracking, and monitoring of outgoing and internal referrals to ensure patient safety, care coordination and continuity of care; Assists with healthcare access to manage patient care.
POSITION DUTIES:
- Knowledge and understanding of Employee Handbook.
- Carry out the meaning of the CSMD Mission and Vision statements.
- Practice a culture of safety to reduce or prevent risk of injury, claims, loss or liability by utilizing the Risk Management and Infection Control Plan.
- Perform responsibilities with a high-quality standard to yield improved compliance, quality, and patient outcome measures by adhering to the Quality Improvement Plan.
- Be present and ready for work as scheduled.
- Attend in-service trainings, departmental meetings, and community events.
- Work cohesively with team members.
- Maintains a database of health center referral contacts throughout Baton Rouge and CSMD service areas, specifically within agencies providing health and social services to patients.
- Acts as liaison to hospitals, specialty clinics, other providers outside of CSMD to track and monitor referrals.
- Coordinates referrals to health services based on provider's orders.
- Ensures that all documentation is completed and in the electronic medical record (EMR)
- Maintains updated referral resources
- Upholds and completes referrals to ensure the entire referral process is complete
- Initiates authorizations for referrals through insurance payors
- Ensure that referrals are addressed in a timely manner
- Outreach to patients and health agencies on status of referrals
- Works closely with Health Information Technology department and Care Coordination to ensure timely coordination of care.
- Works closely with Clinical Care Team to assist with coordinating appointments for patients
- Promptly reviews all incoming referrals for "critical need" or attention required immediately by the provider.
- Adheres to all CSMD policies and procedures.
- Other job duties as assigned.
REQUIREMENTS:
Education:
- Minimum of high school diploma
- Preferred Certified Medical Assistant or Licensed Practical Nurse or associates in a health field
- Minimum of three years of experience with working referrals;
- Demonstrates a high level of skill at building relationships and providing excellent customer service
- Inhibits a strong attention to detail and accuracy
- Has the ability to utilize computers for data entry and information retrieval
- Demonstrates knowledge of the referral process for a variety of insurance plans
- Demonstrates success in researching and resolving complex issues
- Must have strong written and verbal communication skills.
- Must have pleasant telephone etiquette; ability to deal tactfully and effectively with patients; must have strong computer skills, use of Microsoft applications and familiarity with electronic health records.
- Must be critical-thinking and detailed-oriented.
SUPERVISES
N/A
TRAINING
Relias Track A Non-Clinical
Relias CareSouth Onboarding
PERFORMANCE MANAGEMENT EVALUATION TYPE
Patient Engagement
PHYSICAL REQUIREMENTS:
- Visual acuity - always
- Hand – eye coordination – always
- Manual Dexterity – always; fine manipulation of keyboard
- Lifting approximately 10-15 lbs.,
- Pushing, Pulling - sometimes
- Stooping, Bending, and Standing - sometimes
- Walking- frequent; short distances
WORK ENVIRONMENT:
- Indoor, environmentally controlled
- Exposure to disease or infections
- No vibrations
- Exposure to artificial and/or natural light
- Exposure to outdoor weather elements