Moscow, ID, United States
Nov 17, 2020
OverviewnReferral Specialist Lead perform a variety of clerical and administrative tasks in accordance with hospital policies and protocols, as well as federal, state, and local regulations applicable including absolute confidentiality of all patient related information in compliance with HIPAA guidelines. In addition to mastering and routinely performing the Admitting Services Representative responsibilities, the Referral Lead also performs all of the below major job functions.nQualificationsnRequired SkillsnThis person must have excellent customer service skills, excellent written and verbal communication skills, a positive attitude, and must support and demonstrate the Gritman Way values and behavioral standards.n nMust have the ability to work closely with others, have a pleasant attitude at all times and be willing to exceed the expectations of patients, visitors, providers and coworkers.n nMust be able to work and complete tasks with little supervision.n nMust have experience working with computers and have the ability to document and communicate via office systems. Some education and/or experience in Medical Office are preferred. On the job training is provided.nResponsibilitiesnFront Office Dutiesn This person must provide high quality reception support and customer service to our patients, providers and staff in a caring and supportive manner. Performs opening and closing duties of office and maintains front office and waiting room throughout the day including ensuring office is free of safety hazards. Handles telephone communications, patient check-in and check-out, processes incoming documents (both paper and electronic), labels, categorizes, and routes documents according to office procedure and protocols. Use office equipment such as computer, telephone, printers, facsimile, copier, scanner, label printers, coffee machine, water cooler, and other office supplies and equipment as needed.n nFunctional Demands (The Office Staff employee is to complete all necessary tasks, including but not limited to the list below) Open the building according to protocol. Close the building according to protocol. Verify cash box count and the beginning and end of every shift and complete daily reports and reconciliation per protocol. Prep clipboards for daily appointments per protocol. Review AccuReg on a daily basis (preferred) and no less than on a weekly basis and make applicable corrections. Collect co-pays and outstanding patient balances per protocol. Track and maintain patient visits, certification and plan of care dates under the supervision of the Business Lead Answer the phone 15 minutes prior to opening of clinic and until clinic closes for the day. Check voicemail prior to clinic opening, throughout the day, and prior to close. Create patient cases and route appropriately for all health related messages. Keep front area and patient waiting room clean and organized. Sanitize using proper protocol throughout the day and after contagious patients are seen. Keep u201cpick-up draweru201d organized and up to date. Greet all patients, vendors, and representatives within 30 seconds upon their entry into our office. Verify identity of all visitors requesting to go past security door in waiting room and confirm that they are being escorted by staff member, have business associate agreement on file, (for vendors), have been cleared though Gritman for purposes of employment, or for purpose of volunteering or shadowing . Check-in patients u2013 promptly register and complete check-in process in EHR Collect/update all demographic and insurance information PRIOR to patients being taken to the clinic area (EXCEPTION: emergency situation). Verify PCP information for all Medicaid patients PRIOR to patient appointment. Assist patient with completion of any necessary paperwork to transfer PCP and send to insurance company. For changes that cannot be made prior to appointment, notify patient and/or get guidance from director. (DO NOT REFUSE CARE for acute medical care needs.) Verify Workeru2019s Compensation information for all work-related injuries. Assist patients in ensuring all paperwork is completed and in order PRIOR to appointment. Scan driveru2019s licenses, other forms of government ID, and insurance information into EHR for all patients according to protocol. Process and/or prepare all incoming and outgoing mail daily. Follow Financial Policy and Financial Assistance Policy, educate patients and assist with providing financial assistance applications. Review and process clinical in-box items in a timely manner following protocol. Monitor patient waiting area for excessive wait times, potential problems, or patient inconvenience, If patients have been sitting longer than 10 minutes past their appointment time, check with staff on expected time that patient will be roomed and promptly report information to patient. Reschedule patients as needed and as requested by team lead, director, or provider. Review Call schedule and each clinic provider schedule daily so that you are aware of who is working, who is on-call, and what healthcare provider resources you have for the day. Ensure all incoming u201cpaperu201d documents are scanned and routed by the end of your shift ( Check-out patients in a discreet and timely manner in the EHR while also ensuring that they have all necessary information, know when they will hear from our office next, and have follow-up appointment scheduled or tickler for next appointment put in system. Ensure that all eligibility and phone issues have been fixed for the next dayu2019s appointments. Support your co-workers and staff and back-up as needed within your legal scope of practice. Secure all medical records, PHI, and cash prior to leaving for the day.n nCollaboration with Office and Clinical Staff Train/Onboard new front office staff. Maintaining signage, voicemail, and forms per policy. Assists with performance evaluations of employees. Assist Massage Therapy Department with Referral related questions as needed. Participates in recruitment process. Review Weekly report from Medical Record/Coding department and correct all errors as needed. Implements chart audits to ensure front office staff are compliant in daily workflow. Provides input into the development of Policies and Procedures for front office workflow. Maintains monthly meeting calendars. Takes meeting notes during meetings and posts to shared drive when they are available for staff. Liaison between all levels of Front Office Staff, Business Lead and Director. Develops and maintains relationships with clinical staff and office staff through ongoing communication and follow-up to ensure patient and provider needs are being met. Round on Office Staff and Clinical Staff as needed to ensure effective working relationships.nReferrals Process referrals for all therapy patients and provide guidance to Admitting Services Representative and Business Lead in order for them to assist with contacting an scheduling patients. Create and maintain effective workflows for the referral process to facilitate patient access to medical care and treatment. Ensure timely and effective communication between healthcare offices and patients. Work with Admitting Services Representative and Business Lead to ensure that all referrals are contacted within one week of receiving their referral. Maintain the referrals portal as needed. Review prior daysu2019 fire roster and ensure that all cancellations and no show patients were removed from the schedule.nDocument Management and Maintenance of Electronic Health Records Works with healthcare providers and offices to obtain records and information required for processing referral requests. Release medical records to other healthcare providers or insurance carriers as appropriate following local, state, and federal regulations and clinic policy. Maintain accurate documentation of the all referral information in the EHR.nCollaboration with Primary Care Providers Develops and maintains relationships with primary care providers and office staff through ongoing communication and follow-up to ensure patient and provider needs are being met. Creates and maintains referral tools and resources for PCP offices and works with office staff to ensure adequate supply is available.n nPolicy and ProceduresAssists in the development, implementation and review/maintenance of tools and resources that support compliance with policies and procedures.nEducationThe referrals specialist works with the clinics coordinators and clinic director to provide education and feedback to clinic staff and providers regarding process; documentation requirements for successful, timely referrals and prior authorizations.nORGANIZATIONAL EXPECTATIONSProvides a positive and professional representation of the organization.Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.Maintains hospital standards for a clean and quiet environment.Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.Participates in ongoing quality improvement activities.Maintains compliance with organizationu2019s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.Complies with organizational and regulatory policies for handling confidential information.Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in The Gritman Way.nFUNCTIONAL DEMANDSNeonatal, pediatric, adolescent, adult, and geriatric. All genders, race, ethnicity, sociopolitical and socioeconomic demographics, marital and sexual preferences groups, developmental and physical abilities, religions, and nationalities served.Environmental ConditionsIndoors. Exposure to limited amount of outdoor environment when sitting at Front desks. Exposure to ice and snow during winter months when entering/exiting building and ensuring entrances are clear and de-iced for customers and visitors. Exposure to public germs and viruses. Drag Edit DeletePopulation Served:Physical DemandsFast paced office environment that requires the ability to prioritize as the situations occur. Some lifting (<35 lbs), reaching, pushing, pulling, twisting, bending, stooping, kneeling, up and down from computer to other equipment, typing, reading small print, reading computer screens, sitting and standing are required for this job. Requires corrected vision and hearing to normal range, constant talking, hearing, and seeing to interact with patients, visitors, and staff.