SUMMARY
Upholds and supports the philosophy, objectives and policies of the office under the direction of the office manager and physician(s).
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following as well as other duties and responsibilities that may be assigned.
- Responsible for the accurate completion and processing of referral requests from CNHF PCP’s as well as from other PCP’s to other providers, e.g. specialists, DME, diagnostic testing, etc. Also responsible for the processing of follow up referral requests from specialists following the timeliness guidelines in the Policy and Procedure Manual.
- Ensure that phone calls are answered promptly and courteously and that the correct information is relayed to the caller as appropriate
- Responsible for the upkeep of the current Provider Directory to ensure that the correct contracted providers are being referred to.
- Maintenance of referral logs.
- Responsible for maintaining DHS and NCQA standards and requirements.
- Responsible for notifying patients of the status of their referral in a timely manner; Stat referrals in 2 hours. Urgent in 24 hours, regular in 3-4 days, mammography results in office within 7 days and Specialist consultation reports within 30 days. To include phone call, mail or by fax as is necessary and/or appropriate.
- Responsible for accurate filing of referrals in patients charts with all needed documentation.
- Act as patient liaison between the UM/QM Departments and the Health Plans to help the patient access care more readily.
- File all necessary information in patient’s charts, e.g., copies of insurance cards, X-Ray reports, lab reports, hospital notes, referrals, consult notes, etc.
- Assist the physician with other duties as requested.
- Display a friendly, professional attitude with patients, other staff and the Physicians.
- Keep patient records confidential.
QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SKILLS AND SPECIFICATIONS:
- Ability to handle confidential and sensitive information.
- Ability to communicate effectively on the telephone.
- Ability to relate to persons with diverse educational, socioeconomic and ethnic backgrounds.
- Ability to handle a “call center” environment; work quickly and multi-task.
- Ability to exercise good judgment to handle calls appropriately.
- Ability to demonstrate good customer service.
EDUCATION and/or EXPERIENCE:
High School Diploma, Bi-Lingual English and Spanish preferred, CPR Certification preferred
WORKING CONDITIONS: Working conditions 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 qualified individuals with disabilities to perform the essential functions. Variations in conditions may occur under certain circumstances.
Job Type: Full-time
Pay: $21.00 - $25.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Retirement plan
- Vision insurance
Weekly day range:
Experience:
- Insurance verification: 1 year (Preferred)
- Referral: 1 year (Preferred)
Language:
Work Location: In person