39372BRExtended Job Title:Patient Referral CoordinatorOrg Level 1:Texas Tech Unv Hlth Sci Ctr El PasoPosition Description:Serve as a liaison between insurance and healthcare providers to ensure the timely coordination, and accurate processing, of patient referrals required for medical specialty visits.Requisition ID:39372BRTravel Required:Up to 25%Major/Essential Functions:
Prioritize referrals by following and applying standard policies, procedures and practices.
Employ multiple tracking mechanisms to ensure all referral approvals have been received, and the patient receives their appointment in a timely manner.
Ensure patients are always cleared for their appointment prior to their arrival.
Enter progress notes and other pertinent information into the electronic health record (EHR) based on application of departmental practices, policies and procedures.
Review referrals to confirm or obtain insurance authorization. Notify referring provider/service, and return referrals missing required prior authorization.
Identify, by applying knowledge of provider sub-specialties, the appropriate provider with whom to make an appointment.
Schedule required ancillary services needed to prepare for patient appointments. Follow up with patient to ensure completeness.
Determine if preliminary testing (i.e., imaging) is needed based on established departmental practices and procedures. Responsible for explaining to patient, assisting with scheduling and for completeness prior to office visit.
Review details and expectations about the referral with patients. Provide education to patients about available payment options in the event the provider does not participate in their insurance.
Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
Act as the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns.
May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
Ensure that referrals are addressed in a timely manner, and in accordance to departmental expectations/requirements.
Ensure that patient's electronic health record (EHR) is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
Consistently practice and ensure compliance with all HIPAA regulations and confidentiality guidelines.
Provide occasional cross-coverage to the Prior Authorization team to ensure operational needs are met.
Adhere to all policies, procedures and practices (Regents Rules, TTUS, HSECEP OPs, etc.).
Personally demonstrate, display and act in accordance with TTUHSC EP's Values (Service, Respect, Accountability, Integrity, Advancement, and Teamwork). Serve as a Value's ambassador while actively promoting and encouraging staff across the institution.
Perform all other duties as assigned.
Grant Funded?:NoMinimum Hire Rate:Compensation is commensurate upon the qualifications of the individual selectedPay Basis:HourlyWork Location:El PasoPreferred Qualifications:
Previous experience processing patient referrals.
Previous experience providing patient financial counseling.
Previous experience working in an academic medical/health sciences center.
Excellent communication (written and verbal) and interpersonal skills.
Ability to assist patients in understanding and navigating the referral process.
Knowledge of medical terminology, insurance policies, and referral management processes.
Bilingual - English and Spanish.
Campus:HSC - El PasoDepartment:Assc Dean Clinical Affairs ElpRequired Attachments:Resume / CV, TranscriptJob Type:Full TimePay Statement:Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. For additional information, please reference the institutional pay plan website (https://app4.ttuhsc.edu/payplan/) .Job Group:Information and Records ClerksShift:DayEEO Statement:All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, disability, genetic information or status as a protected veteran.Required Qualifications:
Associate’s degree plus one (1) year of experience directly related to the processing of patient referrals; OR
High school diploma or GED plus three (3) years of experience working as a Certified Medical Assistant; OR
High school diploma or GED plus five (5) years of experience directly related to patient registration, patient scheduling, patient billing/collections, the processing of prior authorizations, and/or the processing of patient referrals.
Does this position work in a research laboratory?:NoJeanne Clery Act:The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. To view this report, visit the TTUHSC Clery Act website (https://www.ttuhsc.edu/emergency/clery-report.aspx) .