Transition of Care Specialist (Medical Referral Clerk)

SUMMARY: Provides patient information for all individuals who are given a referral for treatment from a Medical Specialist.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Develop and maintain ongoing system to track, update, and close outstanding referrals back 1-2 years.
• Provide appropriate documentation on referrals to promote team awareness and ensure patient safety. This tracking may use an IT database.
• Review documentation that comes back from specialists and communicate urgent needs with ARMS providers
• Ensure complete and accurate registration, including patient demographic and current insurance information.
• Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.
• Communicate with patients delays or concerns about missed appointments.
• Assign referrals to the appropriate status and follows up if not complete.
• Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.
• Assist patients in problem solving potential issues related to the health care system, financial or social barriers (ex., request interpreters as appropriate or prescription assistance)
• Identify and create documentation of all primary community resource specialists. Keep list and requirements up to date continuously.
• Ensure that referrals are addressed on the same day, 24 hours at max.
• Remind patients of scheduled appointments via mail or phone.
• Ensure that patient’s primary care chart is up to date with information on specialist consults.
• Provide reports on referral process as requested.
• Availability to perform patient care duties when needed in the clinic.
• Works closely with clinical staff to close all referrals including following up with patient and external clinics, scanning documentation, and sending information to the appropriate clinical resource.
• Follows up and closes all diagnostic testing orders as well as external referral orders. If needed, schedules diagnostic testing.
• Perform other duties as assigned

EDUCATION AND EXPERIENCE:

High School Diploma, required

3 years of experience a Clinical Referral Clerk, preferred

OTHER SKILLS AND ABILITIES:

Effective Communication skills, written and spoken

Knowledge of general corporate operations

Strong Customer Service focus

Organized and able to manage competing priorities

Good judgment

Resourcefulness in problem solving