Job Description

Bilingual Referral Coordinator

ChenMed

Were unique. You should be, too. Were changing lives every day for both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

The Care Coordinator is a highly visible customer service and patient-focused role. The incumbent works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel to ensure the referral process runs smoothly. Operations are dynamic and professional, ensuring the highest level of quality healthcare is delivered to our members.

Essential Job Duties/Responsibilities

• Coordinates and processes patient referrals to completion with precision, detail and accuracy.
• Prioritizes HPP patients in the Primary Care Physicians panel, expedites and orders within 5 days.
• Orders have been approved when needed.
• Schedules patient (Preferred Providers List of Specialists) and notifies them of appointment information, including date, time, location, etc.
• Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and other approved web IVRs) for authorization processing.
• Completes orders with proper documentation on where patient is scheduled and how patient was notified.
• Referrals have been sent to specialist office & confirmed receipt.
• Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and guide; communicates physician/clinician needs or outstanding items regarding patients.
• Enters all inpatient and outpatient elective procedures in HITS tool.
• Ensures patients external missed appointments are rescheduled and communicated to the physician/clinician.
• Participates in Super Huddle and provides updates on high priority patient referrals.
• Addresses referral-based phone calls for Primary Care Physicians panel.
• Completes and addresses phone messages within 24 hours.
• Checks out patients based on their assigned physician/clinician; if unavailable, a colleague shall assist (does not apply to Care Specialist).
• Retrieves consultation notes from the consult tracking tool.
• Follows up on all Home Health and DME orders to ensure patient receives services ordered.
• Provides extraordinary customer service to all internal and external customers (patients and other ChenMed Medical team members) at all times; utilizes patient messaging tools.
• Performs other related duties as assigned.

Knowledge, Skills & Abilities

• Knowledge of medical terminology, CPT, HCPCS and ICD coding desired.
• Detail-oriented with the ability to multi-task; open to cross-functional training in referrals and back-office duties.
• Able to exercise proper phone etiquette with ability to navigate computer software systems proficiently.
• Team-oriented; works professionally and courteously with patients, colleagues, physicians and other personnel.
• Exceptional organizational skills with ability to prioritize and complete tasks timely.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and related database/presentation software.
• Ability and willingness to travel locally within the market up to 10% of the time.
• Spoken and written fluency in English; bilingual a plus.

Education & Experience Criteria

• High School diploma or equivalent required.
• A minimum of 1 year of referral experience in a healthcare setting required.
• Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
• Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
• Healthcare experience within the Medicare Advantage population preferred.
• Medical Assistant certification preferred.
• CPR for Healthcare Providers preferred.

Job Information

• Seniority level: Entry level
• Employment type: Full-time
• Job function: General Business and Management
• Industries: Medical Practices

Location: Houston, TX

Salary: $1,500.00-$3,800.00

Posted: 1 month ago

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