Referral Clerk

Coplin Health Systems (CHS); Ravenswood (WV); On-site; USD 26,000 - 33,000; Full time

Job summary

Coplin Health Systems in Ravenswood, WV is seeking a referral clerk to coordinate all patient referrals across primary care, dental, pediatrics and behavioral health. The role involves documenting referrals in the EMR, contacting insurers for prior approvals, and ensuring all tests are completed and results reported in a timely fashion.

You will liaise with providers and staff to ensure smooth care transitions, inform patients of appointment schedules, and help address barriers to access.

Qualifications

• Must have strong communication and confidentiality per HIPAA guidelines.
• Professionalism with patients, colleagues, and others.
• Proficient computer and medical terminology skills.
• Ability to reason and solve problems within healthcare workflows.
• NRCMA or LPN preferred; associate degree with experience considered.

Responsibilities

• Coordinate all referrals from multiple departments within Coplin Health Systems.
• Maintain accurate referral documentation in the EMR. Ensure continuity of care and patient safety.
• Prepare and assemble necessary patient health and demographic information for referrals.
• Contact organizations and insurers to confirm prior approvals as required.
• Ensure labs/imaging/tests for referrals are documented and available for review.
• Assist with scanning and reviewing referral documentation and inform providers of urgent results.
• Keep patients informed about appointment dates and expectations.
• Assist patients in resolving healthcare, financial, or social barriers to access.

Skills

Communication

Confidentiality

Professionalism

Computer Skills

Medical Terminology

Reasoning Ability

Cultural Competence

Education

NRCMA or LPN preferred

Associate degree + relevant experience considered

Tools

EHR systems

Referral coordination tools

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

Position Reportsto: Care Manager Coordinator

FLSA Requirements: Non-Exempt

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

Security and Background 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.

Department of Homeland Security

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.

Other requirements of 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.