Referral Coordinator (Talbott)
SUMMARY (full-time/40 hours)
Complete referrals to specialists to insure the highest level of care necessary to address their medical needs when that need exceeds the scope of our care by utilizing a team based model.
- Conducts all communication with patients in a courteous and professional manner.
- Prepares all pre-authorizations and pre-certifications for TennCare MCO referrals to specialists based on the direction of the medical provider.
- Prepare all re-authorizations and pre-certifications for all commercial HMO, PPO and Medicare patients.
- Schedules all patient appointments with the specialists and notifies the patient with date, time and directions.
- Documents/files referral information in the patient chart.
- Input authorization numbers/pre-certification numbers into the data system.
- Prepares referrals for approved Emergency Room visits.
- Maintains patient tracking logs of referrals; specialists, appointments.
- Advise patients of pertinent clinic programs for which they may apply.
- Provides patients information regarding social service agencies.
- Request and releases confidential information according to established guidelines on confidentiality.
- Cross-trained in all clinical nursing responsibilities to substitute if necessary.
- Participates in Quality Improvement (QI), Quality Assurance (QA) and Continuous Quality Improvement Activities (CQI) as appropriate.
- Other duties as assigned.
Education & Experience:
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Prior medical experience as a medical assistant, certified nursing assistant, and LPN preferred.
Must possess the ability to communicate verbally and non-verbally with clients, coworkers and members of management. Excellent professional customer service skills required.
To perform this job successfully, an individual should have knowledge of Work Processing software and Electronic Medical Records software.
CHS is an EEO Employer