Referral Coordinator

POSITION: Referral Coordinator (340)
DEPARTMENT: Medical
REPORTS TO: Senior Medical Clinic Manager
LOCATION: Native American Health Center, Inc. (NAHC)
2950 International Blvd., Oakland, CA 94601
WORK HOURS: Full Time, 40 Hours per week, 100% FTE
STATUS: Union, Non-Exempt

POSITION SUMMARY
The Referral Coordinator (RC) is key member of the Medical department and is responsible for managing patients’ medical referrals to specialists, ancillary services, and to other NAHC departments. The RC will track all referrals in patients’ electronic health records, work closely and proactively with the clinical care pods (i.e., providers, MA’s, RN’s, Care Coordinators) to ensure patients’ referrals are effectively managed from start to finish, and that information is updated and available in the electronic health record (EHR) system. This position requires a high level of customer service.

The Native American Health Center is an accredited institution and adheres to the standards of excellence set forth by the Accreditation Association of Ambulatory Health Care (AAAHC) and the Commission of Dental Accreditation (CODA).

DUTIES AND RESPONSIBILITIES
Referral Coordination
1. Manage and coordinate all referrals generated in the Medical department from start to finish. This will include sending referrals to specialists, ensuring their 
receipt, informing patients of referrals, and following up to see such appointments were kept.
2. Responsible for verifying eligibility and benefits through insurance companies. including prior authorization request. 
3. Responsible for coordinating and processing prior authorizations for each assigned referral.
4. Proactively work with Medical Assistants to ensure follow up on patients’ specialty appointments. 
5. Schedule specialty appointments for patients; notify and remind patients of such appointments by phone and by letters through the United States Postal Service. 
6. Provide patient education on specialty appointments and address all patient questions in a manner that ensures their understanding.
7. Refer patients to NAHC’s Eligibility Specialist as needed to help ensure coverage of care as related to specialists and the insurance they accept.
8. Maintain a tracking system for referred appointments that includes referred date, dates and times of referral appointments, missed appointments, and the recall procedure.
9. Check Referral voicemail once per clinic (at minimum), return calls, and provide referral statuses to patients. Document patient telephone calls in an EHR  Telephone Template.
10. Document all telephone calls and letters in the EHR.
11. Develop and cultivate positive working relationships with specialist providers.
12. Document referral workflows and support Site Director in developing and editing on-boarding materials for incoming staff as related to referral flow and 
management, as necessary.
13. Train incoming staff on referral processes, as needed. This may include one-time trainings, or on-going trainings and on-boarding.
14. Proactively work with RN Clinic Manager, Lead Physician and Site Director to resolve any technical or flow issues regarding referrals.

General Duties
15. Attend internal and external meetings as requested by supervisor.
16. Member Care: Demonstrate understanding and apply working knowledge of safety policies and ensuring safe member practices. 
17. Employee Safety: Safely performs all duties; follows required protective protocols to ensure personal safety as well the safety of others.
18. Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.
19. Quality Improvement: Actively participate in internal quality improvement teams and work with members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards, when assigned. 
20. HIPAA: Keep all protected health information (PHI) confidential and abide by HIPAA policies for the release and disclosure of any PHI. Will report  unauthorized use of disclosure of PHI immediately, to supervisor or HIPAA security officer. 
21. Work well under pressure, meet multiple and often competing deadlines. 
22. At all times demonstrate cooperative behavior with supervisors, subordinates, colleagues, clients and the community.
23. Other duties as assigned by Supervisor.

MINIMUM QUALIFICATIONS
1. Must have high school diploma or equivalent.
2. One year of work experience in a health care setting.
3. Vaccination Level 1: Must be able to provide TB, Physical, seasonal flu and proof of Vaccination immunity for Measles, Mumps, Rubella, 
Varicella, TDAP & Hepatitis B, prior to start date. If vaccination records are more than 10 years old, titers are required to confirm immunity.
4. BLS/CPR certification must be obtained prior to start date and kept current at all times. 
5. Computer literate and have experience with Microsoft Office suite (Word, Excel, Outlook), and be savvy in Excel.
6. Knowledge of medical terminology.
7. Sufficient skill in typing; have the ability to type a minimum of 25-30wpm.
8. Must be well organized; set priorities appropriately; and work extremely well independently as well as within a team.
9. Possess excellent customer services skills and interact with the public in a courteous, professional and tactful at all times.
10. Excellent communication skills, both verbal and written; must have the ability to communicate effectively with multiple audiences.
11. Must be able to exercise independent judgment, be analytical and solution-oriented.
12. Fluency in both English and Spanish, both written and verbal, may be required, per operational need. 
13. Committed to working with a medically underserved community. 

PREFERRED QUALIFICATIONS
1. An AA degree is preferred.
2. Diploma or certification from an accredited medical care program (i.e. Medical Assistant, Medical Administrative Assistant.)
3. Previous experience with Electronic Health Records (EHR).
4. Experience working with i2i databases. 
5. Previous experience working in a community health center is desirable.
6. Knowledge of managed care, ICD-9, ICD-10 and CPT codes is preferred.

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is frequently required to talk or hear. The employee is frequently required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

WORKING CONDITIONS AND ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly exposed to both an inside/outside environment.

Benefits: Native American Health Center (NAHC) considers our employees to be our most valuable resource and offers an excellent benefit package: competitive salaries, personal time off (PTO) or sick/vacation leave program, and an employer contribution 403(b) retirement plan to full-time regular status employees. We also provide medical, vision, dental, flexible spending, group term and voluntary life insurance coverage for employees and their dependents—with a percentage of employee contribution for dependent medical premiums.
 

Note to Applicants: Please be advised a post job offer, pre-employment Physical, TB test and Vaccination Clearance are required as a condition of employment. Vaccination Levels: 0 – Limited - require only TB, Physical & Seasonal Flu; 1 – Full Panel with exposure of Blood Borne Pathogens – requires, Measles, Mumps, Rubella, TDAP, Varicella, Hepatitis B, TB, Physical & Season Flu; 2 – Full panel no exposure of Blood Borne Pathogens – requires Measles, Mumps, Rubella, TDAP, Varicella, TB, Physical & Seasonal Flu. Additionally, you may be asked to get a Department of Justice Fingerprinting and/or Federal, State, County criminal background check clearance as a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at NAHC.

EQUAL OPPORTUNITY EMPLOYER: Within the scope of Indian Preference, all candidates will receive equal consideration without regard to race, color, gender, religion, national origin or other non-merit factors.
Age Discrimination in Employment Act (ADEA): Native American Health Center abides by the mandates of the ADEA (protecting individuals 40 years and older) and considers age a non-merit factor in all employment decisions and considerations.
Americans with Disabilities Act (ADA): Native American Health Center abides by the mandates of the ADA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, NAHC will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities.