SSMC - Referral Coordinator

South Shore Health System; Norwell (MA); On-site; USD 26,000 - 37,000; Full time

Job summary

South Shore Health is seeking an Ambulatory Access Coordinator I - Referrals in Norwell, MA. The role involves handling inbound calls, routing to extensions, and guiding patients to appropriate providers.

Responsibilities include processing specialty and internal referrals, updating the EMR, obtaining insurance authorizations, and communicating with patients and facilities to support care needs. Strong customer service and Epic experience are preferred.

Qualifications

• High school diploma or equivalent is required.
• 1 year of experience in a healthcare setting is required; Epic experience preferred.
• Excellent customer service and communication skills; proficient with Microsoft Office.

Responsibilities

• Answer incoming calls promptly and route to the correct extension.
• Process outgoing specialty referrals and update EMR with status changes.
• Obtain insurance authorization and communicate issues to patients/facilities.
• Monitor EPIC/MyChart messages and transcribe referral orders and approvals.

Skills

Customer service

Communication skills

Computer skills

Teamwork

Time management

Education

High School Diploma

Tools

EPIC

Job description

Ambulatory Access Coordinator I - Referrals

Facility: LOC0027 - 141 Longwater Norwell141 Longwater Drive Norwell, MA 02061

Department Name: SMC Provider Support Services

Status: Full time

Budgeted Hours: 40

Shift: Day (United States of America)

Compensation Pay Range: $19.10 - $27.30

ESSENTIAL FUNCTIONS

1. Log onto phone system at scheduled time and answers all incoming calls in a prompt, courteous and helpful manner, routing them to the appropriate extension and responding to requests for information.
2. Processes outgoing specialty referral requests for all patients:
   • Reviews each referral to determine special services/procedures being requested.
   • Informs the patient of providers/facilities used by SSMC and provides contact information so the patient may schedule the appointment.
   • Updates the patient’s referral within the EMR to reflect status changes and document additional information as needed.
   • Obtains insurance-specific authorization and communicates to patients and/or facilities with insurance issues.
   • Provides referring facility with clinical information needed to support medical necessity or continuation of care.
   • Communicates requests from patients who wish to seek care outside SSMCs preferred providers
   • Communicates issues to PCP/Triage via Telephone Encounters.
   • Transcribe and processes faxed referral requests.
   • Monitor EPIC messages including, but not limited to, MyChart messages for referral requests by transcribing referral order and securing referral authorizations.
3. Processes internal specialty referral requests for all patients:
   • Reviews each referral to determine special services/procedures being requested.
   • Updates the patient’s referral within the EMR to reflect status changes and document additional information as needed.
   • Obtains insurance-specific authorization and communicates to patients and/or facilities with insurance issues.
   • Communicates requests from patients who wish to seek care outside SSMCs preferred providers.
   • Communicates issues to PCP / Triage via Telephone Encounters.
   • Transcribe faxed incoming referral requests.
   • Monitor EPIC messages including, but not limited to, MyChart messages for referral requests by transcribing referral order and securing referral authorizations.
4. Works independently to complete daily assignments by the end of the shift and long term assignments by established deadline.
   • Efficiently manages work schedule to accomplish assignments and activities before deadline.
   • Works independently with infrequent need for supervision.
   • Informs supervisor when not able to meet deadline.
5. Embraces technological solutions to work processes and practices.
   • Accepts changing environment as technology advances, willing to learn new techniques and equipment.
   • Receptive to changes in department work processes and practices.
   • Seeks appropriate guidance for new techniques.
   • Offers suggestions for change to improve department.
   • Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization.
   • Embraces technological advances that allow us to communicate information effectively and efficiently based on role.
6. Staff will work to enhance the patient experience in every interaction.
   • Demonstrates professional courtesy in all interactions with patients and coworkers.
   • Answers all questions in a polite, professional manner or finds someone who can answer the question.
   • Able to handle difficult patients or situations in a calm, professional manner.
   • Able to report issues/concerns using the chain of command.
7. Staff is able to independently manage daily office functions:
   • Able to perform multiple work tasks efficiently and effectively.
   • Able to maintain a high level of concentration at all times.
   • Able to work under pressure and to maintain composure during stressful situations.
   • Able to complete tasks according to assigned deadlines.
   • Utilizes critical thinking and problem solving in day to day operations as well as in emergent situations.
   • Communicates appropriately and effectively following chain of command.
   • Demonstrates dependability and flexibility in meeting scheduling needs of the department.

JOB REQUIREMENTS

Minimum Education High school diploma or equivalent

Minimum Work Experience One (1) year of experience in healthcare setting required Epic Experience preferred

Required additional Knowledge and Abilities Excellent customer service skills Excellent verbal and written communication skills Excellent computer skills with knowledge of various software applications including Microsoft office (Word, Excel, Outlook) Excellent interpersonal skills Ability to meet demanding deadlines and balance multiple tasks Ability to work both independently and as part of a team to complete daily assignments by the end of the shift and long term assignments by established deadline. Detail oriented with excellent organizational and prioritization skills Mon-Fri 8-4:30 Responsibilities if Required: Education if Required:

License/Registration/Certification Requirements: Basic Life Support (BLS) Certification - American Heart Association (AHA) (Including courses offered through SSH)

South Shore Health is a not-for-profit, charitable health system offering primary and specialty care, hospital care, home health and community care, emergency and urgent care, and preventative and wellness services. We are the largest independent health system in Southeast Massachusetts. South Shore Health brings together like-minded people who work "As One" toward a common goal of providing exceptional care the people of our region deserve. We unite top-caliber talent, technology, and service with the wishes and personal needs of patients and their families to develop individualized treatment plans.