Referral Specialist

The Referral Specialist is responsible for providing assistance to the care management team by working collaboratively to support patient care plans and needs. Functioning as a liaison between the patient, CCHC care management team and outside entities (e.g., hospital systems, home care agencies, specialty offices etc.), the Referral Specialist will serve all the clinic departments and must be able to process, manage and negotiate successful tracking and coordination of referrals. This position requires technical clerical tasks, customer service/interpersonal skills, independent judgment, personal initiative, conflict resolution and multi-tasking at a high skill level. The Referral Coordinator will be part of the care management team and work in tandem with care managers, healthcare providers and community-based organizations to improve outcomes for patients they serve.             

CCHC Core Requirements

1. Patient Centered Customer Service – Whether directly or indirectly, we work to support the delivery of an excellent patient experience to everyone served by the organization.
2. Caring and Compassion – We provide empathic comfort to those in distress and share kindness in all interpersonal interactions.
3. Respectful Communication – We communicate openly, honestly and without judgment while honoring each individual’s uniqueness and assuming the best of those with whom we interact.
4. Teamwork – We are members of a diverse interdisciplinary team working together to meet a common goal.
5. Accountability – We accept our individual and team responsibilities, and we meet our commitments. We take responsibility for our performance and actions.
6. Customer Safety – We recognize and correct potential hazards to protect our customers and ourselves.

• Engages with patients to identify and address barriers as it relates to referral loop closure and communicates with care management team
• Implements and support Care Management interventions per the patient’s care plan or assessed community needs as it relates to referrals
• Processes referrals from members of the multidisciplinary team (social work, behavioral health, community resource coordinators, pharmacy, pharmacy technician, care managers) and outside entities appropriately, accurately and timely according to established workflows
• Track and enter all referral requests
• Verify insurance status/information for referral purposes
• Ensures referral loop closure process is complete (i.e., process, document, track, and follow up) on all referrals until external notes are uploaded into the patient’s EHR.
• Routine reminder and follow up calls are made to patients and outside entities.
• Provides education to patient/family within scope of practice
• Serves as a liaison among the patient/family, community services, primary providers, specialists, and other care team members to coordinate services
• Participates in Quality Improvement initiatives to improve efficiency and effectiveness of patient health outcomes
• Adheres to CCHC privacy and security policies
• Abides by Health Center guidelines, policies and procedures, and HIPAA regulations
• Attends departmental and corporate meetings, local and regional training's, or other events as required
• Performs other duties as assigned
• Works under the direct supervision of the Care Management Supervisor

-Minimum of (3) three years of office clerical and/or referral experience in an ambulatory, acute care setting, or public health.

-Evidence of essential leadership, education, counseling skills, and strong interpersonal skills; ability to work with colleagues across sites.

-Proficiency in communication technologies (email, cell phone, etc.)

-Highly organized with ability to keep accurate notes and records

-Experience with health IT systems and reports is desirable

-Local knowledge about and connections to community health care and social welfare resources is desirable

-Bilingual preferred but not required

-Ability to travel to other clinical sites when needed

Experience: Minimum of (3) three years of office clerical and/or referral experience in an ambulatory, acute care setting, or public health.

Additional skills required 

-Core values consistent with a patient and family-centered approach to care

-Demonstrates professional, appropriate, effective, and tactful communication skills, including written, verbal and nonverbal

-Demonstrates a positive attitude and respectful, professional customer service

-Acknowledges patient’s rights on confidentiality issues, maintains patient confidentiality at all times, and follows HIPAA guidelines and regulations

-Proactively acts as patient advocate, responding with empathy and respect to resolve patient and family concerns, and recognizes opportunities for improvement to meeting patient concerns

-Proactively continues to educate self on providing quality care and improving professional skillsProficient in the use of Microsoft Office programs to produce correspondence, documents, presentations, records and spreadsheets. Excellent verbal and written communication skills. Highly organized with ability to keep accurate notes and records.

Additional skills preferred: Expert knowledge of medical office operations. Familiarity with role of FQHCs in the community. Experience with health IT systems and reports is desirable.

Education: High school diploma or GED Certification(s)/Licensure: completion of certificate program in healthcare area of focus. Current and active certification or licensure from an accredited school or program. 

Physical Demands and Work Environment:

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. All duties and responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities.  

The physical demands associated with this position include but are not limited to: frequent lifting, bending, climbing, stooping, and pulling; frequent repetitive motions; continuous standing and walking; repetitive movement of hands and fingers (typing and/or writing); lifting of greater than 50 pounds.  

The noise level in the work environment is low, consistent with that of a typical office.