Referral Clerk

Coplin Health Systems; North Ravenswood (WV); On-site; USD 32,000 - 42,000; Full time

Job summary

Coplin Health Systems in Ravenswood, WV seeks a Referral Clerk to coordinate patient referrals across departments, ensuring timely processing and accurate documentation in the electronic health record.

Responsibilities include verifying demographics and insurance, obtaining prior approvals, tracking referrals, notifying providers of outstanding items, and assisting front desk and medical records while prioritizing patient safety.

Qualifications

• Experience with HIPAA guidelines and patient confidentiality.
• Familiarity with electronic health records and referral workflows.
• Strong communication and interpersonal skills.

Responsibilities

• Coordinate all referrals for patients from multiple departments.
• Verify patient demographics and insurance information in the EHR.
• Obtain prior approvals and ensure referral requirements are met.
• Track referrals and communicate status to care teams.
• Assist front desk and Medical Records staff as needed.

Skills

Communication

Confidentiality

Professionalism

Computer skills

Medical terminology

Reasoning ability

Cultural competence

Education

NRCMA/LPN preferred

Associate degree or equivalent

Referral/patient navigation and/or billing/medical records experience

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Staff Full Time Staff Ravenswood, WV, US

9 days ago Requisition ID: 1076

Department Name: Administration – Front Office Position

PositionReportsto:Care Manager Coordinator

FLSA Requirements: Non-Exempt

DateUpdated:October29,2024 Location:

JOBSTATEMENT/SUMMARY

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

ESSENTIALFUNCTIONS&RESPONSIBILITIESOFTHEPOSITION

• Maintainsongoingtrackingandappropriatedocumentationonreferrals intheelectronicmedical recordssystem topromote clinicalteam awareness, ensure continuityofcare andpatient 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 laboratorytesting, 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 serviceproviders (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.

JOBREQUIREMENTSANDPREFERREDQUALIFICATIONS

• Communication(spokenandwritten)
• Confidentiality(accordingtoHIPAAguidelines)
• Professionalism(withpatients,colleagues,andothers)
• ComputerSkills
• MedicalTerminology
• 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

ThisjobhasNOsupervisoryresponsibilities.

WORKINGCONDITIONS

This job operates in a professional office environment. This role routinely uses standard office equipment such as laptop computers and smartphones. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The noise level in the work environment is usually moderate with frequent interruptions. The employee must occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected. Employee may be asked to work or travel to any site within the organization for work purposes.

DISCLAIMER

Thisisnotanall-inclusivejobdescription;therefore,managementhastherighttoassignorreassign schedules, duties and responsibilities to this job at any time.

PHYSICAL/ENVIRONMENTALDEMANDS

Thetablebelowshowshowmuchon-the-jobtimeisspentinthefollowingphysical activities:

Activity

None

Under 1/3

1/3to 2/3

Over 2/3

Standing

X

Walking

X

X

Usinghandstofinger,handleor

feel

X

Reachingwithhandsandarms

X

ClimbingorBalancing

X

Stooping,kneeling,crouchingor

X

Talkingorhearing

X

Tastingorsmelling

X

Driving

X

Liftingupto25pounds

X

This position is described as light physical activity job. Specific vision abilities required by the job includeclosevision,distancevision,colorvision,peripheralvision,depthperceptionandtheability to adjust focus. Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.This job operates in a professional office environment.This role

routinelyusesstandardofficeequipmentsuchaslaptopcomputersandsmartphones.Thenoise level in the work environment is usually moderate with frequent interruptions.

CONDITIONSOF EMPLOYMENT

SecurityandBackground Requirements

If not previously completed, a background security investigation will be required for all applicants.Appointmentwillbesubjecttotheapplicant'ssuccessfulcompletionofabackground

security investigation and favorable adjudication. Failure to successfully meet these requirements may begroundsfor appropriatepersonnelaction. Inaddition,ifhired,abackgroundsecurityreinvestigation or supplemental investigation may be required at a later time. Applicants are also advised that all information concerning qualifications is subject to investigation. False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action.

DepartmentofHomelandSecurity

Ifyouareselectedforthisposition,thedocumentationthatyoupresentforpurposesofcompleting the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS.

Direct Deposit

Allemployeesarerequiredtohavebi-weeklypaymentsmadebydirectdeposittoafinancial institution of their choosing.

Otherrequirementsof employment

• 60-dayprobationaryperiodisrequired.
• DrugScreeningisrequired.
• WVCares Clearance

EEOSTATEMENT

CoplinHealthSystemsprovidesequalemploymentopportunities(EEO)toallemployeesandapplicants foremploymentwithoutregardto race,color,religion, gender, sexualorientation,national origin,age, disability or genetics. In addition to federal law requirements, Coplin Health Systems complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Coplin Health Systems expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Coplin Health Systems’ employees to perform their job duties may result in discipline up to and including discharge.

ACKNOWLEDGEMENT

I acknowledge that I have reviewed this job description, that I understand the requirements of this position,thatIamqualifiedandabletoperformtherequirementsassociatedwiththisposition,and that the job description may be revised by Coplin Health Systems at any time.