Referral Coordinator

SUMMARY

The Referral Coordinator is responsible for assisting Clinic staff and physicians in ensuring that Clinic medical records are maintained in accordance with written policy and guidelines meet all State, Tribal and Accreditation standards, are accurately documented, and strictly protect the confidentiality of all patients. Works closely with the Medical Assistant/Registry Clerk and will be required to share the respective duties of this position on a regular basis.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintain patient confidentiality as per Health Insurance Portability and Accountability Act (HIPAA) of 1996 and complete HIPAA compliance training.
• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety. This tracking may use an IT database.
• Ensure complete and accurate registration, including patient demographic and current insurance information.
• Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information Medical Records Clerk.
• Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and patients.
• Review details and expectations about the referral with patients.
• Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
• Monitors medical records to make sure charts are complete, up to date, and include all appropriate information such as accurate patient identification and demographic information, appropriately signed consent forms, pertinent medical history, assessment of the health status and health care needs of the patient, initial assessment including patient vitals, chief complaint and symptoms as described by the patient, etc.
• If proper information and documentation are not included in the medical record, works with Clinical staff to make sure missing information is put into medical record.
• Ensures that all documentation is appropriately signed and dated.
• Properly places all physical examination reports, and diagnostic and laboratory test results in chart.
• Protects the confidentiality of all patient charts at all times.
• Serves on staff quality improvement committees such as Chart Review Committee and conducts periodic chart reviews to monitor quality of medical records.
• Photocopies medical records to release with proper patient consent. Pulls charts for next days appointments; pulls charts for afternoon appointments. Collaborate with nursing staff in pulling charts for walk-in patients.
• Re-files charts in timely manner throughout the day. Attends trainings, seminars, etc., for professional development.
• Collect information regarding patients utilizing all GTB health services, including Health Clinic, Community Health (CHR's, BCCP, etc.), Behavioral Health, AFS, Optical, etc.
• Coordinate with Contract Health Services to integrate patient data.
• Consult with staff and management regarding eligibility and registration issues.
• Keep updated regarding "user pop" and eligibility issues/trends. Educate other GTB personnel about new guidelines, regulations, etc.
• Coordinates and implements special medical records projects as assigned.
• Must be proficient with numerical systems for charts.
• Maintain patient confidentiality at all times.
• Follow all Front Reception policies and procedures to include maintaining face sheet responsibilities.
• Greet patients in a timely and appropriate manner either in person or on the phone.
• Ensures that all patients sign a current release form as required for HIPAA compliance.
• Work with Health Applications Coordinator to ensure patients are eligible for Clinic services prior to being served.
• Complete and distribute patient appointment schedules to appropriate staff per policy.
• Alert nursing staff and physicians about changes in daily schedule.
• Maintain records of daily no-shows and walk-in-patients.
• Follow appropriate procedures for walk-in patients.
• Maintain the timely flow of patients/visitors in and out of the waiting room.
• Assist other staff as needed and accept other duties as assigned.

OTHER SKILLS AND ABILITIES

• Must have excellent verbal and written communication skills.
• Must have excellent interpersonal skills with demonstrated patience, tact and respect.
• Must have exceptional detail and follow-up skills.
• Must have proven proficiency in computers, including Microsoft Windows Operating System and Microsoft Office Suite and the Resource Patient Management System (RPMS).
• Input and provide statistical data for all health programs on a regular basis.
• Maintain accurate and updated patient information.
• Maintain patient confidentiality at all times.
• Assist clients in completing registration process in accordance with Clinic policy.
• Adherence to medical/universal precautions in accordance with GTB Clinic Policies and Procedures.
• Ability to multi-task and to prioritize duties and assignments appropriately and effectively.
• Must provide other clinic/administrative support as needed.

EDUCATION and/or EXPERIENCE

• High school diploma required or GED.
• Medical record certification preferred.
• Prior experience working in a family practice setting preferred. Must have knowledge of medical terminology.
• Should be knowledgeable of accreditation standards.

PHYSICAL DEMANDS

There will be requirements of sitting, walking reaching and some lifting. Able to lift,

Twenty-five pounds to carry and re-file charts. Manual dexterity is necessary for the use of office equipment. Need to be in good physical and mental health. Assisting of patients may be required from time to time.

WORK ENVIRONMENT

The Clinic maintains universal precautions at all times. Staff is expected to be in uniform during work hours if applicable and/or maintain professional appearance.

COMMENTS

Native American preference will apply. Must be willing and able to pass a background investigation and a drug and alcohol urinalysis as a condition of employment. Adherence to strict company policy in regard to confidentiality is a must.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Management retains the right to add or to change the duties of the position at any time through approved motion by Tribal Council. * Any qualifications to be considered as equivalents in lieu of stated minimums require prior approval of the Director of Human Resources.

Current Openings for Referral Coordinator Jobs at Grand Traverse Band of Ottawa and Chippewa Indians