Referral Coordinator (Elk Ridge) - Show Low - Referrals

El Rio; Show Low (AZ); On-site; USD 38,000 - 52,000; Full time

Job summary

Elk Ridge Community Health is seeking a Referral Coordinator for Show Low to coordinate patient referrals, obtain prior authorizations, and maintain EMR documentation. You will ensure timely referrals and accurate payer data, while upholding HIPAA and compliance standards.

The role requires clerical medical office experience, appointment scheduling, and familiarity with AHCCCS/Managed Care plans; a fingerprint clearance card is preferred. Bilingual abilities are a plus.

Qualifications

• Education: High School Degree or GED.
• 1 year of clerical experience in a medical office with knowledge of medical procedures.
• Experience in appointment scheduling and extensive public contact work.
• Experience with AHCCCS and Managed Care plans.
• Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.

Responsibilities

• Provides quality customer service to patients who require a referral to a specialist.
• Arranges appointments; notifies patient and/or family of appointment date and any special instructions regarding the specialist’s appointment.
• Documents all patient services in the EMR and NextGen identifying data, payer codes, CPT, and ICD Codes.
• Maintains standards for productivity, timeliness, and accuracy of all referrals.
• Complies with approved quality control policies and procedures.
• Maintains patient confidentiality by HIPAA and corporate compliance requirements.

Skills

Clerical experience

Medical office

Appointment scheduling

Public contact

Education

High School / GED

Tools

AHCCCS

Managed Care plans

Job description

Referral Coordinator (Elk Ridge) - Show Low - Referrals

Show Low(Elk Ridge), 2650 E Show Low Lake Rd, Ste 1, Show Low, Arizona, United States of America

Job Description

JOB PURPOSE: The Referral Coordinator assures coordination of patient care between Elk Ridge Community Health providers and specialty groups by obtaining, verifying, and providing required information to various health plans to obtain prior authorizations. The Referral Coordinator supports operations by assisting staff with internal and external communication, and by maintaining necessary document flow. The Referral Coordinator assures that the process of referrals meets the assigned time schedules and tracks the documentation of referrals for completion in Elk Ridge Community Health EHR/EMR systems.

The primary goal of the Elk Ridge Community Health Referral Coordinator is to support Elk Ridge’s Mission of providing comprehensive, quality health care that is affordable and accessible to all who may have healthcare needs, by successfully performing the primary essential functions.

Job Functions

• Provides quality customer service to patients who require a referral to a specialist.
• Arranges appointments; notifies patient and/or family of appointment date and any special instructions regarding the specialist’s appointment.
• Documents all patient services in the EMR and NextGen identifying data, payer codes, CPT, and ICD Codes.
• Maintains standards for productivity, timeliness, and accuracy of all referrals.
• Complies with approved quality control policies and procedures.
• Maintains patient confidentiality by controlling the environment and information being disclosed to authorized individuals ensuring HIPAA and corporate compliance requirements at all times.
• Provides a work environment safe and free from hazards; immediately address or inform management of safety issues or potential hazards.
• Adheres to Health and Safety Policies and Procedures; participates in all safety programs, which may include assignment to an emergency response team.
• Contributes to increased productivity by assuring that the processing of referrals meets the assigned time schedules.
• Performs patient assessment by using the appropriate protocol and the appropriate disposition, e.g., initiating provider’s requests for a referral, answering referral inquiries.
• Reports to work at the appointed time and adheres to policies and procedures regarding sick and vacation leave.
• Maintains exceptional level of customer service; address and resolve complaints.
• Actively participates in staff meetings and work toward accomplishing department goals and objectives; works well with all team members and accomplish related results as needed.
• Shares information regarding Elk Ridge Community Health services in the community.
• Reduces expenses by promoting the proper use and care of clinic equipment.
• Properly cleans, stores, and maintains the use of computers, fax machines and copiers for the exclusive use of clinic business.
• Keeps work areas clean and organized at all times.
• Provides training for department staff to ensure efficient referral and authorization process.
• Maintains an organized referral manual with current listing of all health plans.
• Provide follow-up on patient’s referral to assure patient kept specialist’s appointment.
• Promotes Elk Ridge Community Health by modeling good customer service, and encouraging patients to share Elk Ridge information with family and friends.
• Contributes to team effort and complies with all facility policies and procedures including but not limited to those addressing HIPAA and Compliance and performs other duties as assigned.

Qualifications

Minimum Qualifications

Education: High School Degree or General Education Diploma (G.E.D.).

1 year of clerical experience in a medical office with knowledge of medical procedures.

Experience in appointment scheduling and extensive public contact work.

Experience with AHCCCS and Managed Care plans.

Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.

If applicable, equivalent combination of education and experience may be considered, and must be directly related to the functions and responsibilities of the job.

Preferred Qualifications

Courses in anatomy and physiology.

Bilingual (English/Spanish/Navajo) with the ability to speak, read and write in both languages.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Elk Ridge Community Health does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, age 40 and over, disability, genetic information, military status, ancestry, marital status, familial status, or any other status protected by law or regulation.

It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.

All employees are required to undergo drug testing prior to employment and will be subject to post-accident, reasonable suspicion, return to duty and follow up drug and alcohol testing in compliance with Federal and State regulations for alcohol and controlled substance testing. Employees in positions holding responsibility for the safety and welfare of others will also be classified as safety sensitive.

Elk Ridge Community Health is a Non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and abides by all applicable federal Drug-Free Workplace standards.