Referral Coordinator I- CART/Full Time/Days

About the Role

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical, and business professionals across all disciplines.

Schedule

8.5 hour days with 30-minute lunch breaks. Monday-Friday, no evenings or weekends. Hours vary between 8AM-5PM.

Location

Lancaster/East Petersburg, PA

Responsibilities

The Referral Coordinator is responsible for coordinating specialty care and testing for patients in need of external consultations and diagnostic imaging as requested by the Primary Care Physician. This includes but is not limited to obtaining authorizations from insurance and scheduling with External Providers. Ensures compliance with hospital policies, billing guidelines, and payer policies.

• Serves as first-line resource for all customers internal and external with regards to referrals. Must have a basic understanding of the referral process.
• Completes 2 of the following Job Functions:
  • Obtain insurance referrals and authorizations for diagnostic testing and procedures; communicate with referring physicians for peer-to-peer and denials follow-up. Will be required to maintain a working knowledge of insurance verification and authorization.
  • Process patient referrals to specialty providers by preparing medical records and providing appropriate clinical information to the specialist. Communicate appointment information and expectations with patients in a timely manner. Complete outreach to obtain consult notes for completed appointments.
  • Working knowledge of diagnostic imaging scheduling, canceling, and rescheduling process in EPIC. Completes outreach to patients and schedules imaging appointments in EPIC; reviews details and expectations with the patients for their upcoming appointments. Provide follow-up phone calls once consult appointments have been scheduled to notify patients of appointments; as well as outreach to obtain consult notes for completed appointments.
• Maintain appropriate and accurate documentation.
• Adhere to team standards and workflows.
• Attempt to understand patients' needs and offer guidance and resolution of issues through collaboration with team members and outside departments.
• Demonstrate excellent “over the phone” patient relations skills, e.g., smiles, cheerfully greets patients, and engages all patients in a genuine, warm, and caring manner.
• Maintain regular consistent attendance, personal appearance, punctuality, and adherence to applicable health and safety procedures.

The following duties are considered secondary to the primary duties listed above:

• Identify work processes that can be improved upon, eliminated, or handled through electronic processes and escalate to leadership.
• Basic knowledge of Family Medicine Practices, purpose, and operations.
• Basic medical terminology.
• Knowledge of various insurance plans such as Medicaid, Medicare, and Commercial insurances.
• Ability to work efficiently and comfortably with all levels of staff.
• Perform other related duties as assigned.

Requirements

• High school diploma or certificate.
• One year of experience in a healthcare setting.
• One year of experience in a customer service-related field.

Preferred Qualifications

• One year of using medical terminology.
• One year of experience in medical referral insurance.

Skills

Attention Concentration: The position requires the ability to attend to more than one aspect of a situation simultaneously. It is highly likely that multiple task demands are going to be required of the individual at the same time.

New Learning and Memory: The position requires that an individual be able to learn new tasks quickly and effectively. The ability to understand and carry out detailed, involved instructions is mandatory. A large portion of this position requires reliance on verbal memory and new learning. Efficiency in processing verbal information, either in written or spoken form, is a major requirement and prerequisite of the job. The individual must be able to attend to and process multiple bits of information simultaneously and organize and categorize this information effectively for later recall.

Problem Solving, Reasoning, and Creative Thinking: The position deals with issues or problems that often require thoughtful reasoning before arriving at approaches or solutions. Some independent thought, planning, or origination of options and solutions is necessary. The individual must have the ability to apply principles of reasoning and problem-solving to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Communication: Ability to exchange information with others clearly and concisely; to present ideas, facts, and technical information.

Interpersonal Relations: Ability to maintain relationships that facilitate task accomplishment; to cooperate and resolve conflicts; to recognize needs and be sensitive to others.

Benefits

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region.