South County Health is an independent, non-profit healthcare system offering a comprehensive range of advanced inpatient, outpatient and home health services. Accredited by The Joint Commission (TJC), SCH is made up of South County Hospital, South County Home Health, and South County Medical Group. South County Health has received numerous distinctions for patient care and safety over the years, which have included a 5-star rating on HCAHPS scores, a 5-star rating by CMS for overall hospital quality, and A's for hospital quality and patient safety by The Leapfrog Group. Having celebrated over 100 years of service to southern Rhode Island, South County Health offers an exceptional opportunity to provide our patients with the best care possible while enjoying a healthy work-life balance. We offer competitive salaries and an attractive benefits package which includes, health, dental, vision, tuition reimbursement, 403b, PTO, and a broad range of career development benefits and opportunities.
Job Summary:
The Referral Coordinator is responsible for coordinating the process of referring patients to appropriate clinics, updates records to ensure accurate information, communicates with patients and staff to ensure appropriate follow-through with referrals, and supports SCMG physicians in synchronizing appointments, authorizations and tests taking place in different clinics, and works under the direction of a Practice Manager. The Referral Coordinator is responsible for processing, tracking, and facilitating all aspects of referrals made to specialty care providers in a timely, courteous, professional and accurate manner. The Referral Coordinator facilitates all types of referrals for specialty care and serves as a liaison between primary care providers, patients, and specialty care providers. Maintains ongoing tracking and appropriate documentation on EHR referrals to promote team awareness and ensure patient safety; Maintains a current list of approved referral sources and referral guidelines; Contact insurance companies to ensure prior approval requirements are met; Ensures all referral information is complete and submits to referral entity in a timely manner; Review details, patient instructions and expectations about the referral with patients via phone, mail, secure, e-mail, patient portal, or face to face when needed. Addresses barriers and directs patients to areas of assistance, maintaining knowledge of resources and support; Responds to incoming telephone calls, patient portal messages regarding referrals in a timely manner; Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers; Ensure that referrals are addressed in a timely manner. Ensure that the referral tracking report is kept up to date on a weekly basis; Tracks and monitors all referrals to ensure that they are completed and consult reports are received in a timely manner; Ensure that referring providers are kept up to date on the status of all referrals by managing the end-to-end referral processes; Ensure that patient's electronic health record is up to date with information on specialist consults; Notifies Supervisor and/or Manager of any issues regarding referrals including access concerns, trends in barriers of care and any other issue potentially affecting timely patient care; Demonstrate a working knowledge of Patient Center Medical Home approach to care; Ability to know and understand the multiple computer-based information systems; Ability to demonstrate knowledge of various Health Insurance Products; and Ability to work with different project assignments such as outreach and patient engagement efforts.
Minimum qualifications:
Ability to work in a fast-paced environment while delivering excellent customer service required. Experience in a high volume call center preferred. Effective communicator and ability to display professional demeanor under pressure required. Strong computer skills in a Windows environment required. College Degree or equivalent professional experience preferred. Experience in a healthcare environment preferred. Knowledge of medical terminology, healthcare insurances, and ancillary testing preferred. Must be able to operate/utilize fax machine, copy machine, and scanner.
