21890 Colorado AvenueP.O. Box 737 PH 559 693 -2462 San Joaquin CA 93660 FAX 559 693 -3005 JOB DESCRIPTION POSITION REFERRALS SPECIALIST REPORTS TO HEALTH CENTER MANAGER POSITIONS SUPERVISED NONE CLASS REGULAR CAT FULL -TIME NON -EXEMPT BASIC FUNCTIONS The Referrals Specialist will provide assistance to patients in the area of referrals pr e-authorizations education of process and quality of care. The position is specifically responsible for assisting patients with the completion of referral answering questions regarding process and processing referrals received from providers. DUTIES AND RESPONSIBILITIES 1. Assist patients with completion of referrals answering questions regarding process and processing referrals received from providers. 2. Oversee all referral activity with assigned providers and ensure the quality of care is being prov ided to the patients including the appropriateness of referrals and services being rendered. 3. Initiate referral process including necessary tracking and documentation. 4. Maintain a current list of outside SpecialistsSpecialties which includes referral forms prescriptions CPT listings and DX requirements. 5. Document all communications and details during the referral process in electronic tracking system and electronic health record utilize these systems to obtain all necessary information and document all r eferral processing steps. 6. Request medical records from outside SpecialistHospitals. etc. 7. Conduct appointment scheduling in Practice Management System. 8. Maintain office equipment and supplies - includes reporting of IT or facility -related issues. 9. Maintain documentation and status of the specialty referral throughout the process. 10. Responsible for the coordination of referral requests with multiple service lines including in -house non -primary care specialty services and outside medical specialty services re ferrals to hospitals home health dental etc. and obtaining hospital pre -admission as required from the various health insurances and health plans. 11. Handle any ongoing communication between the specialist office ordering providers and patients to ensure an effective working relationship. 12. Provide exceptional customer service and problem solving techniques in an attempt to further the patients overall health and well -being via specialty care referrals. 13. Coordinate with carious insurance carriers to obtain necessary authorizations and pre-certifications for patients to receive necessary services. 14. Schedule patient appointment with specialists as applicable and provides constant communication to the patients regarding the process and referral status. 15. Follow up on referrals processed to determine number of referral appointments cancelled or kept whether documentation was provided by the specialist to the ordering provider and any necessary documentation in chart completed. 16. Ensure any pending referral with missi ng information is appropriately closed and communicated to provider team. 17. Serve as a resource to patients and staff who have questions about referral related items. 18. Provide orientation on the referral process to the new providers and periodic in -services t o existing providers and staff regarding referral process. 19. Ongoing process analysis and streamlining with all internal referral processes. 20. Responsible for submitting referral activity reports to supervisor in order to monitor performance. Job Description Referrals Specialist Page 2 21. Fulfill specific referral productivity metrics as assigned and directed. 22. On a temporary basis may be required to work at any satellite facility. 23. Contribute to team effort by assisting other departments as needed and while maintaining confidentiality of VHTs business. 24. Work cooperatively with all staff members and outside sources in a professional manner to deliver a high level of service. 25. Observe and practice all VHT Patient Experience Service Standards as outlined in World Class Practices My Commitment to Care which I have read and signed. Practice CICARE when interacting with patients their families visitors or internal customers. 26. Practice CICARE phone etiquette during all phone interactions. 27. Always exercise courtesy whenever patients family members visitors an d co-workers are present. 28. Respect privacy and dignity of our patients family members visitors and co -workers. 29. Maintain professionalism in the presence of patients their families visitors and co -workers. 30. Act as a role model verbally and behaviorally demonstrating skill enthusiasm positive problem solving commitment and loyalty to the profession and the organization. 31. Follow applicable regulations Joint Commission OSHA HIPAA and CLIA. 32. Serves and protects the practice by adhering to professional standards policies and procedures federal state and local requirements and The Joint Commission Accreditation of Healthcare Organization standards. 33. Perform other related duties which may be inclusive but not listed in the job description. MINIMUM QUALIFICATIONS 1. High School Diploma or GED equivalency completion of accredited Medical Assistant program preferred 2. Minimum one 1 year work experience in a medical setting andor knowledge with coordinating referrals 3. Current Basic Life Support 4. Strong c ustomer service skills preferably within a service industry 5. Ability to process analyze and streamline processes 6. Ability to communicate effectively both verbal and written 7. Must have strong organization skills ability to multi -task 8. Modern office practice s and procedures including email 9. Fluent conversational EnglishSpanish or EnglishPunjabi preferred 10. Ability to be flexible with work schedule and available to work at all site locations 11. Must have own transportation valid California Drivers License and current proof of automobile insurance coverage 12. Demonstrated ability to provide world -class patient experience using CICARE principles and practices. Ability to be proactive and to go above and beyond the call of duty take initiative to provide a world cla ss patient experience in all encounter s via email phone or in person TYPICAL WORKING CONDITIONS The office setting is a normal work environment. Occasionally work during early morning evening or weekend. May be subjected to temperature variances in the office. TYPICAL PHYSICAL DEMANDS Requires sitting standing or walking for up to eight hours a day. Some bending stretching or reaching may be necessary. Lifting up to 40 pounds may be required on occasion. Vision must be correctable to 2020 and hearing must be in the normal range for telephone contact. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable acc ommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee may come in contact with hazardous equipment such as liquid nitrogen cleaning agents and sharps. T he noise level in the work environment is usually moderate but may become excessively loud with the increased patient flow during a busy clinic day. Job Description Referrals Specialist Page 3 I the employee understand the responsibilities and standards of my position as listed above and I agre e to fulfill them to the best of my ability. I understand I am an at -will employee and can be terminated at any time with or without cause. I also understand the Valley Health Team Inc. will not be responsible in any manner for terminations which are du e to defunding of Federal or State Contracts. I also agree that the VHT Board of Directors have the right to modify the Personnel Policies which govern my employment at any time. This organization is an Equal Opportunity Employer. It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race age color sex religion national origin or other protected classification. ______ Employees Signature Date 21890 Colorado AvenueP.O. Box 737 PH 559 693 -2462 San Joaquin CA 93660 FAX 559 693-3005 JOB DESCRIPTION POSITION MEDICAL RECORDS CLERK REPORTS TO HEALTH CENTER MANAGER POSITIONS SUPERVISED NONE CLASS REGULAR CAT FULL -TIME NON -EXEMPT BASIC FUNCTIONS The Medical Records Clerk has the responsibility for the maintenance of the medicaldent alvision and allied health records of the patients on a rotating basis as they are central to the operations of the clinic. DUTIES AND RESPONSIBILITIES 1. Put up charts with route slip attached for patients as they are being registered. 2. Make new charts as needed organize and change old charts to new format. 3. Print out next days appointments for all providers write outslips pull and clean charts and place in designated area. 4. Update schedule as patients cancel stamp and give No Show" charts to providers . 5. Fill out and mail medical releases for information to and from other agencies. 6. File records from other facilitiessites when they arrive. 7. Communicate with the billing department and copy parts of the record for billing purposes Medicare or Medi -Cal reje cts the claim due to lack of information etc.. 8. Pull medical records daily for patients who are scheduled and make sure that the date of service is noted on the progress note insert any lab results or other results needed for review by the provider as pe r policies and procedures established by VHT and in accordance with licensing and regulatory requirements or as instructed by clinical staff. 9. In coordination with established policies complete insurance eligibility for the next days patients on a daily basis. 10. Check for patient identifying information on all documents. 11. Primarily responsible for securing andor causing the securing of all medical records at the end of each working day. 12. Responsible for inserting all other documents in patients charts in acc ordance with program requirements policies and procedures established at the direction of the clinical staff such as a OB sheets in prenatal chart nutrition questionnaire and diet intake b appropriate growth sheet for age and sex and c problem l ist health maintenance sheet and the like. 13. Pull charts as needed for special audits peer review refill requests and such. 14. Make copies of various forms when required. 15. Mail out requests for records when presented with a properly completed medical release make copies of records in response to incoming medical releases. 16. Call next days appointments to confirm and verify patient information. 17. Respon sible for maintaining office supplies for entire front office staff. 18. On a temporary basis may be required to wo rk at any satellite facility. 19. Contribute to team effort by assisting other departments as needed and while maintaining confidentiality of VHTs business. 20. Work cooperatively with all staff members and outside sources in a professional manner to deliver a hi gh level of service. 21. Observe and practice all VHT Patient Experience Service Standards as outlined in World Class Practices My Commitment to Care which I have read and signed. Practice CICARE when interacting with patients their families visitors o r internal customers. Job Description Medical Records Clerk Page 2 22. Practice CICARE phone etiquette during all phone interactions. 23. Always exercise courtesy whenever patients family members visitors and co -workers are present. 24. Respect privacy and dignity of our patients family members visitors an d co-workers. 25. Maintain professionalism in the presence of patients their families visitors and co -workers. 26. Act as a role model verbally and behaviorally demonstrating skill enthusiasm positive problem solving commitment and loyalty to the profession and the organization. 27. Follow applicable regulations Joint Commission OSHA HIPAA and CLIA. 28. Serves and protects the practice by adhering to professional standards policies and procedures federal state and local requirements and The Joint Commissi on Accreditation of Healthcare Organization standards. 29. Perform other related duties which may be inclusive but not listed in the job description. MINIMUM QUALIFICATIONS 1. High School Diploma or GED equivalency 2. Minimum one 1 year work experience 3. Curren t Basic Life Support card 4. Strong customer service skills preferably within a service industry 5. Strong communication skills 6. Modern office practices and procedures including email 7. Ability to communicate to patients in a pleasant manner and show profession alism at all times 8. Fluent conversational EnglishSpanish or EnglishPunjabi preferred 9. Ability to be flexible with work schedule and available to work at all site locations 10. Must have own transportation valid California Drivers License and current proof of automobile insurance coverage 11. Demonstrated ability to provide world -class patient experience using CICARE principles and practices. Ability to be proactive and to go above and beyond the call of duty take initiative to provide a world class patient exper ience in all encounter s via email phone or in person TYPICAL WORKING CONDITIONS The office setting is a normal work environment. Occasionally work during early morning evening or weekend. May be subjected to temperature variances in the office. TYP ICAL PHYSICAL DEMANDS Requires sitting standing or walking for up to eight hours a day. Some bending stretching or reaching may be necessary. Lifting up to 40 pounds may be required on occasion. Vision must be correctable to 2020 and hearing must be in the normal range for telephone contact. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may b e made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee may come in contact with hazardous equipment such as liquid nitrogen cleaning agents and sharps. The noise level in the work environment is usually moderate but may become excessively loud with the increased patient flow during a busy clinic day. I the employee understand the responsibilities and standards of my position as listed above and I agree to fulf ill them to the best of my ability. I understand I am an at -will employee and can be terminated at any time with or without cause. I also understand the Valley Health Team Inc. will not be responsible in any manner for terminations which are due to defu nding of Federal or State Contracts. I also agree that the VHT Board of Directors have the right to modify the Personnel Policies which govern my employment at any time. Job Description Medical Records Clerk Page 3 This organization is an Equal Opportunity Employer. It is our po licy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race age color sex religion national origin or other protected classification. ____ ___ __ Employees Signature Date