Referral Coordinator - PRMC

Presbyterian System Services; Clovis (NM); On-site; USD 23,000 - 38,000; Full time

Benefits offered by this job

Health benefits

Job summary

Presbyterian Healthcare Services is seeking a Referral Coordinator for Plains Regional Medical Center in Clovis, NM. The role focuses on coordinating referrals, maintaining provider communication, and ensuring timely access to services.

Responsibilities include handling prior authorizations, coordinating with departments, and maintaining accurate scheduling and documentation within the EHR. A strong emphasis on customer service and professionalism is required.

Qualifications

• High school or equivalent.
• Minimum 18 months experience in a medical office setting with significant MD interaction.
• Proficiency in prior authorization/certification/referral process.
• Must pass EPIC competency for Registration at completion of Epic Clerical Training class.
• Short-term training in Medical Terminology.
• Working knowledge of CPT and ICD-10 coding.
• Pass annual competency exam for all areas of responsibility.
• Requires strong organizational and multi-tasking skill sets.
• Significant customer service skill set.
• Must be able to function under pressure while maintaining professionalism.

Responsibilities

• Achieve exceptional experience for providers and referring providers offices by using CARES, AIDET and EPE tools.
• Ensure timely communications with providers and patients.
• Schedule referrals and coordinate provider-to-provider communication as needed.
• Coordinate with departments to gain access for referrals and follow up on referral status.
• Enter faxed referrals into the EHR and assist with prior authorization processes.
• Understand scheduling workflows and ensure necessary medical records are requested.

Job description

Location Address:2100 N Dr Martin Luther King Jr Blvd Clovis, NM 88101-9412Compensation Pay Range:Minimum Offer $16.79 Maximum Offer $27.67 Now Hiring: Referral Coordinator - PRMCSummary:Navigate complex requests from referring providers and their offices, primarily via phone. Develop and maintain positive working relationships with providers and referring offices. Address requests and concerns using knowledge of organization and ability to identify resources; Use high level of diplomatic skill to handle all calls in positive and professional manner. Advanced scheduling for specialty or radiologic procedures; Recognize payor requirements and obtaining prior authorization/certification/referrals for visits/procedures; Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department; Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc Type of Opportunity: Full time Job Exempt: No Job is based: Plains Regional Medical Center Work Shift: Days (United States of America)Responsibilities:Achieve exceptional experience for providers and referring providers offices by using CARES, AIDET and EPE tools.Ensures all communications with providers and patients occurs in a timely mannerCommunicates with referring providers and their offices to schedule referrals, answer questions, and arrange provider-to-provider communication as neededAddresses and attempts to appropriately resolve concerns and requests in the moment by using resources and appropriate escalations to find solutionsCoordinates with departments throughout program to gain access for referralsFollows up with referring providers to ensure they know the status of their referral or requestMaintains strong knowledge of program operations and processes in order to guide referring providers and answer questions about potential referrals and perform appropriate hand-offsCoordinates with Business Development partner to collect feedback from referring offices in order to ensure an exceptional experience.Encounter Components:Ability to manage conflict and appropriately request the help of a supervisor when neededFosters effective patient relations with patients, the public and providers by listening, responding and escalating when appropriateWorks with program providers, testing departments, and health plan representatives to facilitate creating access for referrals and members as neededFacilitates provider-to-provider communication as requested Encounter ComponentsCoordinates incoming referrals from the time they re received to completedEnters all faxed referrals into EHRGuides and assists referring offices through Prior Authorization request requirements and processesUnderstands surgical and procedural scheduling workflows in order to appropriately prepare and hand-off referralsEnsures relevant medical records are requestedEnsures any testing required for referral is ordered and scheduledCommunicates effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as orderedQualifications:High school or equivalent; Minimum 18 months experience in a medical office setting with significant MD interaction; Proficiency in prior authorization/certification/referral process; Must pass EPIC competency for Registration at completion of Epic Clerical Training class; Short-term training in Medical Terminology; Working knowledge of CPT and ICD-10 coding; Pass annual competency exam for all areas of responsibility; Requires strong organizational and multi-tasking skill sets; Significant customer service skill set; Must be able to function under pressure while maintaining professionalismAll benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.WellnessPresbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.Why work at Presbyterian?As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.About Presbyterian Healthcare ServicesPresbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services