Referral Coordinator

Harvard University; Cambridge (MA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Paid time off

Health insurance

Retirement plans

Wellbeing resources

Commuter benefits

Job summary

Harvard University Health Services (HUHS) seeks a Referral Coordinator to facilitate scheduling for diagnostic tests and specialty consultations and to coordinate referrals with outside organizations. You will manage documentation, track referral status, and support patient access to care.

The role requires excellent communication, organizational skills, and familiarity with insurance processes and prior Authorizations. 35-hour work week at Harvard campus.

Qualifications

• High school diploma or equivalent is required.
• Medical secretary/patient service experience is preferred.
• Typing and/or computer skills, telephone skills, and multilingual ability are expected.

Responsibilities

• Schedules diagnostic tests and specialty consultations.
• Tracks referral status in the electronic system and documents visits for PCP follow-up.
• Acts as liaison between patient and inside/outside providers.
• Communicates referral information to patient and provider.
• Enters referral data into Blue Cross Provider Central; obtains prior approvals.
• Initiates process for long or out-of-network referrals with Member Services.

Skills

Medical secretary

Patient service

Interpersonal skills

Customer service

Multilingual

Organizational skills

Education

High school diploma or equivalent

Job description

Company Description

By working at Harvard University, you join a vibrant community that advances Harvard's world-changing mission in meaningful ways, inspires innovation and collaboration, and builds skills and expertise. We are dedicated to creating a diverse and welcoming environment where everyone can thrive.

Why join Harvard University Health Services (HUHS)

Harvard University Health Services (HUHS), part of University Central Administration(CADM),is the on-site multi-specialty medical practice and health administration for the Harvard community. It provides care to students, faculty, staff, eligible post-docs, retirees, and their dependents. HUHS also manages two university-owned health plans, HUGHP and SHIP, and collaborates with other departments to address public health needs.

Job Description

Serves as liaison between patients and providers to schedule diagnostic tests and specialty consultations at outside organizations (prior authorization as needed) and in-house specialty appointments. Obtains date of service and follows up with visit results. Assists patients with tracking referral status in the electronic system. Works collaboratively with Member Services and Care Coordination departments. Office responsibilities include data entry and coordination of mailings. Collaborates with satellite and specialty offices in processing referrals.

Referral Coordinator

• Knowledgeably articulates insurance limitations to patients.
• Tracks referral status in the electronic system and ensures documentation of referral visits is available for PCP follow-up or upon request.
• Schedules diagnostic tests and specialty consultations at outside organizations.
• Assists patients with scheduling in-house specialty appointments.
• Assists patients by providing directions to outside facilities.
• Communicates with outside referral services by telephone, fax, and e-mail.
• Serves as liaison between patient and inside/outside providers.
• Communicates referral appointment information to patient and provider.
• Keeps pre-testing instructions updated from referral organizations.
• Generate reports as requested.
• Work collaboratively with Member Services and Care Coordination department.
• Enters referral into Blue Cross Provider Central
• Enters patient information into Blue Cross Provider Central to obtain prior approvals.
• Initiates process for over 90 days and out of network referral requests in coordination with Member Services.

General Office

• As a member of the clinical care team, assures the safe and satisfactory care of patients.
• Opens and closes the clinic according to written protocol.
• Schedules patient appointments utilizing all functions of the appointment system.
• Completes all the necessary information in scheduling patient appointments.
• Handles all emergency phone calls appropriately, efficiently, and according to emergency protocol.
• Responds appropriately to patient requests for medical record information.
• Types and sends letters.
• Assists patients by providing directions, escorting, transporting, and ensuring their comfort and safety.
• Sets priorities in organizing activities for the day.
• Demonstrates flexibility when unexpected changes in assignment occur.
• Identifies own learning needs and requests assistance from others when needed.
• Documents care provided using appropriate forms.
• Demonstrates the ability to identify and respond to potential life threatening situations during telephone encounters.
• Demonstrates universal precautions in all care delivery.
• Carries out proper procedure for reporting faulty equipment.
• Prepares medical records ensuring that confidentiality is maintained.

Professional / Team Workplace Accountability

• Maintains patient confidentiality.
• Demonstrates respect in all interpersonal interactions.
• Works collaboratively with all members of the health care team.
• Performs all personal business away from patients and all work areas.
• Identifies own learning needs and requests assistance from others when needed.
• Adheres to regulatory guidelines i.e. AAAHC, DPH, OSHA, etc.
• Adheres to departmental and unit specific policies, procedures, guidelines and protocols.
• Participates in orientation of new staff members.
• Attends staff meetings and educational offerings required by the department.
• Provides coverage to other areas as necessary.
• Performs related duties as required.
• Plans for time off in advance and according to clinic policy.
• Provides proper notification for absences or tardiness.
• Is punctual and prepared for duties at start of shift.
• Is reliable and dependable in coming to work.
• Is flexible and responsive to the needs of the clinic and department in regard to work schedule.
• Demonstrates caring and willingness to help in all interactions.
• Cooperates and complies with goals/projects of clinic and department.
• Utilizes time productively.
• Maintains professional conduct and appearance.
• Performs other duties and responsibilities as needed.

Age-Specific Competencies

• Provides care to the adolescent through utilization of the following:
  • Supplements explanations with reasons for “why?”
  • Encourages questions regarding fears.
  • Allows adolescent to maintain control.
  • Realizes there may be resistance.
  • Provides privacy.
• Provides care to the adult patient through utilization of the following:
  • Recognizes anxiety regarding potential chances in lifestyle resulting from illness.
  • Provides education based on learning needs.
• Provides care to the geriatric patient through utilization of the following:
  • Speaks distinctly due to loss of ability to discriminate sounds.
  • Slows pace of explanation due to slowed cognitive functioning.
  • Maintains a safe environment based upon physical and psychological function.

Compliance

• Adheres to the expectations and professional responsibilities of the department.
• Employs the standards, practices, and procedures of the department.
• Completes and complies with HUHS training requirements including HIPAA Privacy and Security.
• Reports non-compliance incidents to the supervisor, manager, and/or Compliance Officer.

Qualifications

Basic Qualifications

• High school diploma or equivalent.

Additional Qualifications and Skills

• Medical secretary/patient service experience.
• Typing and/or computer skills, telephone skills, and multi-lingual.
• Excellent interpersonal, customer service and organizational skills.
• Experience with insurance products and obtaining prior authorization.

Standard Hours/Schedule: 35 hours per week, Monday - Friday

Visa Sponsorship Information: Harvard University is unable to provide visa sponsorship for this position

Pre-Employment Screening: Identity, Criminal

Other Information: This position has a 90-day orientation and review period.

Why join Harvard University Central Administration?

Harvard University's Central Administration (CADM) is a 5,000+ employee organization that supports the university's overall excellence by understanding and serving the needs of its schools, students, faculty, staff, alumni, and surrounding communities. Through dynamic and collaborative partnerships, CADM provides high-quality and efficient services to the schools to help them achieve their goals.

Work Format Details

This position has been determined by school or unit leaders that all duties and responsibilities must be performed at a Harvard or Harvard-designated location. Certain visa types may limit work location. Individuals must meet work location sponsorship requirements prior to employment.

Salary Grade and Ranges

This position is salary grade level 052. Please visit Harvard's Salary Ranges to view the corresponding salary range and related information.

Benefits

Harvard offers a comprehensive benefits package that is designed to support a healthy work-life balance and your physical, mental and financial wellbeing. Because here, you are what matters. Our benefits include, but are not limited to:

• Generous paid time off including parental leave
• Medical, dental, and vision health insurance coverage starting on day one
• Retirement plans with university contributions
• Wellbeing and mental health resources
• Support for families and caregivers
• Professional development opportunities including tuition assistance and reimbursement
• Commuter benefits, discounts and campus perks

Learn more about these and additional benefits on our Benefits & Wellbeing Page.

EEO/Non-Discrimination Commitment Statement

Harvard University is committed to equal opportunity and non-discrimination. We seek talent from all parts of society and the world, and we strive to ensure everyone at Harvard thrives. Our differences help our community advance Harvard's academic purposes.

Harvard has an equal employment opportunity policy that outlines our commitment to prohibiting discrimination on the basis of race, ethnicity, color, national origin, sex, sexual orientation, gender identity, veteran status, religion, disability, or any other characteristic protected by law or identified in the university's non-discrimination policy.