Referral Coordinator

Description

In this role you will offer inbound and outbound phone support while providing operational processing expertise of clinical referrals using telephony and EMR system(s).

The ideal candidate has experience in a contact center environment and can understand the needs of others to meet those needs with great service and operational processing accuracy.

Knowledge of the healthcare industry including reviewing patient charts, insurance and medical billing processes, and EMR / HIN systems preferred but not required.

The ability to have premier service interactions without patients is critical to success in this role, in addition to achieving all processing performance objectives.

How you can make a difference

• Answers all phone calls in a patient, empathetic, and passionately communicative manner
• Deliver on a commitment to solve problems with patience and understanding, providing knowledgeable and thoughtful service to exceed expectations
• Coordinates medical specialty referrals and procedures for patients in a timely, efficient, and equitable manner
• Utilizes EMR system(s) to track and research urgent requests and keep patient information current and accurate
• Communicates information, including updates of referral requests, appointment details, and communication preferences vis telephone, email, chat, and patient portal
• Review patient charts and records to understand what authorizations and documentations need to be pursued
• Ensures that all barriers to care (such as language, transportation restrictions, or financial needs) are addressed
• Provides clear, thorough, and accurate documentation of all interactions with patients, and other individuals on behalf of patients, in the patient’s electronic health records
• Processes necessary prior authorizations and insurance referrals as needed to complete the referral process
• Follows organizational guidelines regarding the use of the Electronic Medical Record (EMR) in compliance with HIPAA and patient confidentiality standards
• Maintains access to the Health Information Exchange (HIN) and other related systems
• Uses HIN and other related systems to gather information needed to coordinate care and keep patients’ electronic health records up to date with the status of care that is being coordinated
• Maintains surveillance ticklers and / or work with Health Information Technology to proactively identify the need for patient care
• Navigates patient to care, as assigned

Skills for success

• A people-first attitude and premier customer service DNA
• A genuine excitement to help patients and process referrals with operational excellence
• A problem solver who can confidently troubleshoot and investigate to answer questions or resolve complaints
• Confident with system processing and updates
• Self-motivated : energetic, self-starter; can work autonomously
• Ability to put yourself in patients’ shoes and advocate for them when necessary.
• Results oriented : bias for action; demonstrated track record of achievement; drive for attainment of superior outcomes
• Flexible : ably navigates within ambiguity; solution-oriented communication; conveys thoughts and expresses ideas effectively both verbally and in writing;

strong presentation skills

• Collaboration : orientation to team-based work product and results
• Service : Actively supports others, demonstrates an optimistic, can-do approach to issue resolution
• Humility : low ego; engenders trust; respectful

Experience to drive change

• Service center excellence, call center preferred
• Experience in the medical or health insurance field preferred
• Knowledge of medical terminology
• Excellent telephone etiquette
• Skilled in basic computer operations and EMR
• Bilingual in English and Spanish preferred
• Excellent interpersonal skills, including, empathy, patience, courtesy, and attentiveness
• Ability to work independently with a strong sense of focus
• Task-oriented, strong organizational skills, ability to multitask
• Strong attention to detail
• High school diploma or GED
• Task-oriented, strong organizational skills, ability to multitask

About Our Commitment

Total Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families.

Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender / sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

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