Referral Tracking Coordinator - Star Community Health

St. Luke's University Health Network - Nurse; Tamaqua (Schuylkill County); On-site; USD 35,000 - 50,000; Full time

Job summary

St. Luke's University Health Network seeks a Referral Coordinator to manage patient referrals and appointments effectively. This role involves strong communication skills, the ability to navigate insurance processes, and maintaining patient relationships to ensure optimum care delivery. Ideal candidates are organized and flexible, thriving in a busy call center environment.

Qualifications

• High School diploma or GED required.
• Bilingual in Spanish preferred.
• Previous call center experience with medical terminology knowledge.

Responsibilities

• Schedule and manage specialist and imaging appointments.
• Respond to patient inquiries and adjust appointments as needed.
• Complete insurance referrals and prior authorizations.

Skills

Customer Service

Data Entry

Organizational Skills

Communication

Bilingual (Spanish preferred)

Education

High School diploma or GED

Tools

Microsoft Office

Epic referral workflow

Job description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Referral Coordinator is a liaison between the providers and the patients. They are responsible for scheduling specialist and imaging appointments for Star Community Health patients. Collaborates with patients and specialty providers offices to get appointments in a timely manner. Obtains knowledge of patients’ barriers for attending an appointment and refers patient to the appropriate service for help. Responds to patient’s questions and needs by editing, canceling and rescheduling appointments according to department protocols. Completes insurance referrals or prior authorizations when necessary. Follow up with specialty offices and patient to ensure patient compliance with attending the appointment. Fluent with EMR to manage an active and fluid work queue of specialist referrals along with necessary documentation of closing the referral loop. Excellent verbal skills are required. Strong computer skills and attention to detail are required.

SCOPE OF DUTIES

• Accurately completes the referral scheduling process with patient via telephone or in-person
• Updates and or communicates correct patient information to appropriate staff, hospital departments, and computer systems. Works with coordinator, supervisor and managers for any scheduling, or insurance issues
• Will meet with patients/patient family in person as needed
• Ongoing knowledge of scheduling and registration procedures
• Works with and communicates to departments regarding patients
• Appropriately refers patients Social Work/Care Management/ Financial Counselors
• Monitors and maintains worklists as assigned, by handling in a timely fashion and according to priority
• Capable of switching between skillsets and outbound, inbound calling functions
• Respond to patient’s questions and needs by editing, canceling and rescheduling appointments according to department protocols
• Project a professional network image through phone interaction (PCRAFT Values)
• Excellent customer service skills with the ability to maintain effective working relationships with patients and staff.
• High level of skill in entering data into computer while conversing with patients and physician offices.
• Provides educational information to the patient regarding their testing.
• Completes pre-authorizations and insurance referrals for referrals and orders
• Acquire and submit all necessary clinical information to insurance company needed to obtain prior authorization in a timely fashion
• Obtains knowledge of any barrier’s patient may have whether transportation, insurance, or work schedule and educates patients on available services.
• Maintains up to date knowledge on insurance guidelines for prior authorizations and referrals.

OTHER FUNCTIONS:

• Other related duties as assigned.

PHYSICAL AND SENSORY REQUIREMENTS:

Sitting for one to two hours at a time, stand for two to three hours at a time, walk on all surfaces for up to five hours per day, and climb stairs. Must be capable of driving a car. Fingering and handling objects frequently. Occasionally firmly grasp, twist and turn objects with hands and fingers. May be required to lift, carry, push, and/or pull objects weighing up to 75 pounds. Occasionally stoops, bends, squats, kneels, and reaches above shoulder level. Must have the ability to hear as it relates to normal conversations and high and low frequencies and to see as it relates to general and peripheral vision. Must have the ability to touch as related to telephone and computer keyboard.

POTENTIAL ON-THE-JOB RISKS:

No identified risks

EDUCATION:

High School diploma or GED

TRAINING AND EXPERIENCE:

· Bilingual- Spanish preferred

· Previous Call Center Experience

· Medical Terminology

· Knowledge of computer systems and programs such as Microsoft Office

· Epic referral workflow experience preferred

Must possess ability to prioritize tasks. Must possess ability to organize workload. Must be flexible and able to adapt. Must be tactful and even-tempered with the ability to follow through on projects with minimal supervision, make independent decisions and use good judgment. Must have excellent organizational skills and productivity to maintain smooth workflow. Must maintain confidentiality of all correspondence, personnel, and operational issues.

Please complete your application using your full legal name andcurrent home address. Be sure toincludeemployment history forthe past seven (7) years, including your present employer. Additionally, you areencouraged to upload a current resume, including all work history, education, and/or certifications andlicenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.