Referral Coordinator - (Full-Time Remote)

Referral Management - Tm GoldJOB SUMMARY
Serves as the central access point for referring providers and assists in meeting key service and financial pillar goals. Utilizes appropriate protocols and resources, critical thinking, and decision-making skills to navigate the patient through service lines to receive care for referred services. Captures patient level demographics, insurance eligibility, and registration details and authorizations prior to service completion. Tests and refines new technology and workflows within PAS to ensure strategic alignment across service lines and in support of the organization’s goals. Supports all aspects of patient coordination and barrier identification to support continuous growth in new patient external referrals and creating a competitive market for our patients and providers.KEY RESPONSIBILITIES• Serves as the decision-making resource and utilizes critical thinking to analyze the needed coordination for patient care associated across multidisciplinary departments• Facilitates timely and efficient referrals and follow up with patients.• Verifies insurance eligibility for all new patients entering VUMC through RMC via automated insurance plan eligibility databases.• Coordinates with insurance entities to investigates, process, and log referral authorizations.• Provides patient estimates based on coverage to support expectation of financial responsibilities.• Conducts outreach efforts with referring providers to provide status updates.• Completes documentation, including demographics and referral information notes and orders.• Mentors and assists new and existing staff by educating others on area-specific knowledge, skills and tools, and departmental processes.TECHNICAL CAPABILITIES• Call Center Telephone Etiquette (Advanced): Able to handle patient or provider calls and contribute positively to the call center working environment. Demonstrates good manners, decorum and appropriate protocols. Avoids and neutralizes conflicts and handles difficult callers in a positive and professional way.• Patient Scheduling (Advanced): The ability to coordinate and schedule patient appointments, surgeries and other office visits with various computer systems in the hospital or clinic.• Customer Service (Advanced): A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.• Patient Satisfaction (Advanced): Participates in patient satisfaction related process improvement activities as well as providing high quality contact experience for the patient with every call. This position also has direct effect on ease of scheduling appointment and ease of getting clinic on the phone.* Organizational Impact: Performs non-routine tasks that significantly impact team's performance with minimal guidance. * Problem Solving/ Complexity of work: Conducts research and analysis to solve some non-routine problems.* Breadth of Knowledge: Applies broad job knowledge and has basic job skills in other areas.* Team Interaction: Provides informal guidance and support to less experienced team members.Supporting Colleagues: - Develops Self and Others: Continuously improves own skills by identifying development opportunities.- Builds and Maintains Relationships: Seeks to understand colleagues' priorities, working styles and develops relationships across areas. - Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner. Delivering Excellent Services: - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service. - Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns in a timely manner. - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support. Ensuring High Quality: - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards.- Ensures Continuous Improvement: Shows eagerness to learn new knowledge, technologies, tools or systems and displays willingness to go above and beyond.- Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department. Managing Resources Effectively: - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service. - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources. - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error. Fostering Innovation: - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them. - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action. - Adapts to Change: Embraces changes by keeping an open mind to changing plans and incorporates change instructions into own area of work.Relevant Work Experience3 yearsBachelor's