Referral Coordinator

Harbor Health Services is an innovative, growing, mission-based
organization that lives, serves & collaborates with our community
members to achieve our mission to help individuals reach their full
potential through access to local, affordable services that promote
health. Harbor provides medical, behavioral health, dental, & support
services to more than 34,000 patients in Boston, the South Shore, & Cape
Cod. Harbor Health also operates two Programs for All-Inclusive Care for
the Elderly in Mattapan & Brockton, providing comprehensive healthcare,
transportation & social services for more than 450 frail elders who
continue to live with dignity & independence in the community & a Woman,
Infants & Children (WIC) Nutrition Program. To help further the mission
of Harbor, we are looking for an extremely talented Referral Coordinator
to join our Team. Role: The Referral Coordinator is responsible for
processing patient insurance referrals, consultations, & diagnostic
procedures relating to patient care which includes knowledge of
insurance companies & their covered services. In addition, the Referral
Coordinator will act as a Patient Navigator, contacting patients to
provide appointment dates & times as well as any necessary testing
needs. Responsibilities: Processes referrals/authorizations using
appropriate method provided by insurance companies. Acts as a liaison
between insurance & healthcare providers to ensure required referrals
have been processed correctly for medical specialty visits.
Documents/updates records to ensure all parties have accurate
information. Communicates with patients to ensure follow-through with
referrals or other care related needs. Supports care team & patients in
synchronizing care with specialist & diagnostics offices. Communicates
with specialist offices to ensure medical records are received back in a
timely manner. Accurately charts all information in EHR/EMR. Functions
as a resource for patients around managed care plans, insurance &
referral issues, with an ability to perform electronic insurance
verification. Schedules appointments, makes follow up calls & documents
appointments; faxes referral information to physician offices &
diagnostics centers. Answers phone calls, takes messages & responds to
routine patient, physician & client inquiries. Provides support &
information to patients & providers to problem solve & manage complex
administrative issues. Maintains satisfactory productivity rates &
ensures the timeliness of claims reimbursement while maintaining work
queue goals. Ensures that the orders are processed within the
department?s service levels. Requirements: High School diploma or GED 2
years of experience working in a professional healthcare environment
Understanding of HMO, Managed Care, & other Third-Party Insurers
Knowledge of multiple on-line registration insurances websites
Electronic Medical Records & Electronic Practice Management experience,
EPIC/OCHIN desired Knowledge of Medical Terminology required Excellent
verbal & written communication & customer service skills. Intermediate
computer literacy with Microsoft Office applications: Word, Outlook,
Excel Excellent office machinery skills: faxing, scanning, copying & use
of phone system Ability to work independently & as part of a team
Ability to prioritize & execute a variety of tasks within a short period
of time & work under stressful conditions Must be able to articulate &
communicate clearly in English. Bilingual English/Vietnamese/Portuguese
or Spanish highly desired. Position will be hybrid with 3 days on-site
work required at the Harbor Community Health Center-Hyannis.