Referral Management Coordinator

About the role

We serve more than 500 medical centers and 130 onsite clinics nationwide, and our colleagues are fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner.

Responsibilities

The Referral Management Coordinator maintains high standards for quality and an exceptional patient experience in accordance with Concentra’s policies, procedures and applicable regulations. The Referral Management Coordinator processes referrals requests and authorizations while working closely with physicians, employers and payors.

• First point of escalation for all case related issues requiring guidance
• Responsible for daily completion of assigned patient referrals, while meeting production requirements
• Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market
• Obtains authorization for Specialist referrals and schedules appointments accordingly
• Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable
• Provides all necessary information such as medical records, prescriptions, etc. to payor
• Communicates with stakeholders, payor, employer, and patient as appropriate
• Records all appropriate information via OA/CR module of OccuSource per Concentra policy
• Builds relationships with provider, employer and payor communities
• Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor
• Handles calls according to the call guidelines of the department
• Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions

Qualifications

High school diploma or GED equivalent, with an Associated Degree from an accredited college preferred. At least one year of demonstrated experience in a medical environment, with experience with Worker's Compensation preferred.

• Proficiency with scheduling/insurance verification software
• Familiarity with Microsoft Excel, Outlook, Word
• Excellent communication skills and ability to communicate effectively with colleagues at all levels of the organization
• Ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Excellent time management skills including the ability to multitask and prioritize in a fast-paced environment
• Ability to build and maintain productive business relationships
• Exemplary ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism

Benefits

• 401(k) Retirement Plan with Employer Match
• Medical, Vision, Prescription, Telehealth, & Dental Plans
• Life & Disability Insurance
• Paid Time Off & Extended Illness Days
• Colleague Referral Bonus Program
• Tuition Reimbursement
• Commuter Benefits
• Dependent Care Spending Account
• Employee Discounts

Additional Information

This job requires access to confidential and critical information, requiring ongoing discretion and secure information management. Concentra is an equal opportunity employer, including disability/veterans, and will make decisions regarding employment opportunities without regard to certain characteristics, including race, color, national origin, religious beliefs, sex, age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.

Must be a current Texas Resident and remain a Texas Resident during the duration of employment within the Referral Department. Must be able and willing to travel to a local Concentra to complete first day new hire orientation.