Appointment & Referral Clerk

Position Summary:

Schedules and coordinates all related activities of patients for referral medical care provided by licensed practitioners external to the enterprise, usually for specialized services, by performing the following duties personally. Responsible for ensuring that all critical tasks are fulfilled on a timely basis.

Critical Tasks:

• Maintains exclusive focus upon patients, the quality of their care, and their individual needs without significant distraction by non-patient contact activities and related position duties.
• Complies fully with all patient/resident records and information privacy regulations, state and federal.
• Takes all steps necessary to fully ensure patient/resident and medical data confidentiality and security.
• Maintains accurate and continually updated knowledge of all information required for referred care and connected billing purposes to ensure proper services to patients and receipt of payment from insurance carriers.
• Thoroughly reviews referring provider medical notes and directives to ensure proper referral services actions.
• Greets and directs patients and their family members while assisting individuals with the referral services appointment process.
• Establishes access to necessary patient information prior to or upon arrival of the patient and/or prior to scheduling of referral services appointments.
• Makes appropriate changes to and updates of patient information in computerized medical records system.
• Utilizes multiple computer applications, electronic hardware and printed data sources simultaneously while ensuring that all recorded data is complete/accurate and remains accurate and separated as required by policy.
• Verifies insurance coverage/limitations and obtains all necessary advance authorizations from insurance carriers.
• Maintains updated and accurate knowledge of tribal regulations as they relate to coverage based upon geographic residence locations and tribal membership.
• Differentiates primary and secondary insurance coverage accurately and explains those subjects to patients and their representatives in an understandable style.
• Schedules referral services appointments according to referred provider availability and degree of medical severity and sends appointment confirmation communications to the provider and the referred patient electronically and/or by mail. When necessary, communicates with patients through Public Health Nursing staff.
• Sends all necessary and required electronic or printed health records to referred providers.
• Assists with other medical office needs such as filing, non-referred appointment scheduling, and handling telephone inquiries.
• Enters all data on a timely basis with full accuracy and scans documents for record keeping purposes while ensuring proper data system inclusion of all patient information and documents.
• Conducts reminder calls to patients as necessary and takes all actions necessary to ensure patient attendance at scheduled referral services appointments.
• Maintains complete organization of all work activities and work materials.
• Demonstrates ability to regularly change priorities to accomplish all tasks despite frequent interruptions.
• Demonstrates ability to clearly communicate, both orally and in writing, while performing all essential functions. Demonstrates ability to relate to diverse cultures and specifically the Gila River Community and/or other Native · American cultures and community health services.
• Performs other special projects and duties as assigned.

Required Qualifications:

• High School diploma or GED, with an Associate degree in a health care field preferred.
• One to three years of experience in a health care patient facing role with refined clerical and record keeping experience.
• Accomplished knowledge of medical terminology gained through education and/or work experience.
• Demonstrated ability to relate to diverse cultures and specifically the Gila River Community and/or other Native American cultures.
• Interest in medical subjects, patient services/care, and customer service.
• Prior medical environment work experience is preferred.