CLASSIFICATION/STATUS: Non-Exempt, Full Time, Permanent (40 hours/week Monday-Friday)
IMMEDIATE SUPERVISOR: Site Manager
SUPERVISORY RESPONSIBILITIES: None
FLEXIBLE WORK: In-person/ Hybrid
SALARY: Band 1 $19.00 - $25.00 / hour
WHO YOU ARE:
YOUR ROLE & IMPACT:
The mission of Charles River Community Health (CRCH) is to partner with individuals and families so they can thrive and lead healthier lives by delivering comprehensive, integrated, and equitable primary healthcare. The Referral Coordinator will work collaboratively with primary care practices, specialty practices, referring physicians, insurance carriers, patients, and other parties to ensure that required referral management referrals and prior authorizations for specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems for patient appointments. The Referral Coordinator will utilize available reports to follow up on unresolved issues and denied claims. Additionally, the Referral Coordinator will manage logistics, including appointment arrangements, transportation, and translation services, and will support the Lead Referral Coordinator in managing the electronic referral system.
YOUR RESPONSIBILITIES:
1. Coordinate all outgoing/incoming referrals and prior authorizations.
2. Check voicemails, emails, and teams messages throughout the day and work on EHR Inbaskets/Workqueue daily.
3. Schedule referral appointments, including urgent requests, radiology exams, procedures, and consultations.
4. Verify insurance eligibility and submit insurance referrals and prior authorizations to ensure services are covered.
5. Document appointment information on EHR, notify provider and patient with details, and mail out appointment letters.
6. Prepare documentation, including office notes and labs, to fax to specialist offices for upcoming appointments.
7. Collaborate with the primary care provider to resolve issues related to specialist availability and patient needs.
8. Process insurance referrals and prior authorizations received by fax and phone line from patients and hospitals.
9. Maintain up-to-date knowledge of insurance company requirements and where patient’s insurance is accepted.
10. Function as a resource for information and problem-solving for patients, primary care providers, referral management program staff, specialists, and Health Center staff.
11. Maintain and follow through on closing the loop on all tracked referrals.
12. Maintain HIPAA compliance at all times.
13. Understand the mission of the Health Center and strive to work collaboratively with Health Center staff to carry out this mission.
14. Attend appropriate meetings to maintain up-to-date knowledge of Health Center activities and follow up with the supervisor for information if unable to attend meetings.
15. Maintain documentation to meet audit requirements and participate in audit activities as requested.
16. Perform other duties as assigned by the Director of Operations/Site Manager or designee.
YOUR QUALIFICATIONS, COMPETENCIES, TRAITS:
1. High school diploma or GED required.
2. Previous experience in a healthcare setting is required.
3. Detail-oriented with strong communication and organizational skills.
4. Familiarity with referral management plans and computer skills preferred.
5. Team-oriented, with a strong commitment to helping others.
6. Bilingual in Spanish preferred but not required.
7. Ability to complete 50-60 referrals per week depending on complexity.
8. Willingness to work flexible hours to meet the organization's needs/demands.
9. Excellent communication skills, particularly with people from diverse cultures, with the ability to understand the community, population, and patients we serve.
10. Experience with diverse cultures, with a strong commitment to promoting Diversity, Equity, and Inclusion and reducing inequities.
11. Belief in the work we do at CRCH, with a strong passion to serve underserved populations in diverse settings.
12. Ability to work from home in a quiet, professional setting.
13. Wi-Fi/internet access at home to perform the job remotely. If notified in advance of a disruption to service, or if there are ongoing issues with Wi-Fi, must work in the office until issues are rectified in either the Brighton or Waltham location.
WHO WE ARE & WHAT WE DO:
Charles River Community Health’s mission is to partner with individuals and families so they can thrive and lead healthier lives by delivering comprehensive, integrated, and equitable primary healthcare. CRCH is a comprehensive practice providing medical, pharmacy, dental, behavioral health, optical, and vision services to diverse underserved local communities. We serve over 13,500 patients annually, with 90% of those served being low income, while over 70% need services in a language other than English.
We are committed to providing patients with timely access to the right care, at the right place, and at the right time, collaborating with other organizations to connect patients with a comprehensive range of services and provide continuity of care, and creating new community partnerships to meet the changing needs of patients and the community.
We value caring for everyone with dignity, respect, and compassion, reducing cultural, financial, and other barriers to care, and eliminating health care disparities for our patients. We also advocate for the needs of our patients, the community, and public health causes.
OUR PROMISE:
If you are passionate about providing access to quality and compassionate care to the underserved, you will find your career rewarding and impactful. As Referral Coordinator, you will be part of a dynamic team and will find a partner in your career path goals and trajectory!
OUR BENEFITS & PERKS:
* Medical & Dental Insurance
* Short & Long-term Disability Insurance
* Generous Paid Time Off
* Flexible Spending Account
* Employee Assistance Program
* Tickets at Work
* Health Reimbursement Arrangement
* Travel Reimbursement
* Professional Development Opportunities
* Solid track record of developing and promoting employees internally!
Charles River Community Health is strongly committed to diversity and a workplace environment that respects, appreciates, and values employee differences and similarities. By providing and supporting a work culture that fosters and builds upon diversity and its strengths, CRCH will better serve our local communities and continue to provide quality patient care and services.
CRCH is an employment at-will organization and an equal opportunity employer committed to maintaining a work and learning environment free from discrimination on the basis of sex, race, color, religion, national origin, pregnancy, gender identity, sexual orientation, marital/civil union status, ancestry, place of birth, age, citizenship status, veteran status,
#J-18808-Ljbffr