Referral Specialist II

Referrals Specialist II- Medical Assistant

Are you passionate about helping the underserved?

Western NC Community Health Services (WNCCHS) is a non-profit, Federally Qualified Community Health Center (FQHC). We provide patient centered, team-based primary care to residents of Western North Carolina.

We are seeking a Referrals Specialist II (RS II) with excellent customer service skills. The RS II will be working collaboratively with physicians, nurses, case managers, and other departments to coordinate continuity of care between providers and community specialists. The Referrals Specialist II brings clinical knowledge to referral management and is responsible for receiving, processing, and following up on all medical referral requests for diagnostic testing, medical specialists, and other providers.

The Referrals Specialist II is an in-person role at

Minnie Jones Health Center (MJHC)

257 Biltmore Avenue

Asheville, NC 28801

MJHC is only open during the day, Monday through Friday from 8 am to 6 pm.

Therefore, our staff is not required to to work evenings, nights, weekends or WNCCHS observed holidays .

KEY RESPONSIBILITIES :

• Monitors the electronic health record to receive and process requests for referrals and diagnostic imaging.
• Makes medical referrals to outside agencies according to WNCCHS policies and procedures, ranging from 10-25 referrals a day.
• Proactively reviews new referrals and diagnostic imaging prior-authorization requests for completeness and accuracy.
• Obtain prior-authorization for medical services as needed.
• Reviews details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable.
• Complete and send electronically, via fax or secure email, all the forms required by the outside provider from whom the patient will receive services.
• Ensures complete demographic, insurance information and appropriate / pertaining clinical information is sent to referred specialists.
• Maintains ongoing tracking and appropriate documentation within the referral to communicate referral status and progress.
• Link patients to outside public / private assistance programs (e.g., Mission Charity Care, Project Access).
• Prioritizes referrals by their urgency and addresses them in a timely manner.
• Follows up with the referrals in a timely manner to assure that appointments are made for appropriate care or testing.
• Point of contact for patients and specialists for any questions or rising concerns. Assist in problem solving potential issues related to their referral due to language or social barriers. If unable to help, assist in finding the right point of contact to further help.
• Ability to navigate, read and interpret the patient's electronic medical record for diagnoses, CPT / ICD-10 codes, orders, labs, and imaging (i.e., MRIs, CT Scans, Ultrasounds, X-rays, etc.)
• Participate in mandatory in-services, drills, staff meetings and other trainings.
• Perform duties in a prioritized, organized, and orderly manner to maximize efficiency and productivity.
• Facilitate the maintenance of a clean, neat and well-organized work area.
• Participate in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and / or controlling program goals, objectives and / or services.
• Support current incentive, regulatory, and certification requirements (such as Meaningful Use, PCMH and UDS) through documentation, participation in initiatives, and other activities as directed.
• Perform other duties as assigned.

QUALIFICATIONS :

CERTIFICATION :

PREFERRED SKILLS :

WORK / LIFE BENEFITS

FINANCIAL WELL-BEING BENEFITS

CAREER GROWTH BENEFITS

Western North Carolina Community Health Services is an equal opportunity employer, and all qualified applicants will receive consideration for employment, services, programs or activities without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Hiring range : $19.50 to $23.00 per hour.