Job Description

GENERAL PURPOSE:

The is responsible for scheduling and coordinating the daily referral activities for multi-specialty group practice and providing appropriate services to patients

RESPONSIBILITIES:

• Refers patients to or registers patients with the appropriate specialist
  • Determines the reason for the referral visit and prioritizes as necessary
  • Assures those appropriate prerequisites are completed prior to appointments
    • Reinforces patient care instructions
    • Documents in the medical record
  • Schedules procedures for patients
    • Obtains verification
    • Monitors and controls appointment information
  • Assists the MBCHC OB/GYN team in the coordination of deliveries and surgical procedures
• Follows appropriate managed care guidelines for referral management
  • Keeps abreast of all rules, regulations, policies, and procedures pertaining to the managed care program
    • Coordinates with Jackson Memorial Hospital (JMH)
      • Schedules appointments and registration for patients referred to specialty and/or ancillary services
      • Assures those appropriate prerequisites are completed prior to appointments
      • Sends appropriate documentation and reports to JMH clinics
    • Sends appropriate follow-up letters
    • Keeps all patient information confidential
• Obtains and scans results of open orders into the EHR
• Quality Control
  • As part of quality control efforts, the designated referral coordinator(s) is/are responsible for:
    • Reviewing assigned bin(s) to organize documents by each individual patient
    • Using two (2) patient identifiers, review each page of the referral
    • Documents in preparation for mailing
    • At least twice a day, fold documents to prepare for mailing
    • Ensure each envelope has the MBCHC return addressed stamp
    • As part of quality control efforts, the designed referral coordinator(s) assigned to quality control, is/are NOT responsible for:
      • answering phones
      • processing orders
• Other duties as assigned by supervisor

KNOWLEDGE, SKILLS, AND ABILITIES:

• Knowledge of medical terminology, CPT, HCPCS, and ICD coding desired
• Detail-oriented with the ability to multi-task. Must be open to cross-functionally training in referrals and back-office duties
• Able to exercise proper phone etiquette with the ability to navigate proficiently through computer software systems
• Team-oriented with the ability to work extremely well with patients, colleagues, physicians, and other personnel in a professional and courteous manner
• Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks

EDUCATION AND EXPERIENCE CRITERIA:

• High School diploma or equivalent required
• A minimum of 1 year of relevant work experience in customer service, patient referrals, and/or insurance verification
• Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred
• Bilingual (English/Spanish or Creole) preferred

Company Description

Miami Beach Community Health Center, Inc. (MBCHC) is a fully integrated ambulatory care medical facility that has been providing primary health care in Miami-Dade County since 1977. Our mission is to provide our patients with a patient-centered medical home with high quality, affordable primary health care, and specialty services, chronic disease management, and support services. MBCHC has two locations on Miami Beach and one in North Miami. Services provided include internal medicine, family medicine, pediatrics, obstetrics and gynecology, HIV/AIDS services, dental, endocrinology, ophthalmology and optometry, psychiatry and behavioral health, podiatry, and geriatrics. All three locations have laboratory and pharmacy services. MBCHC pharmacies have 340B pricing. Free medication is available for patients through pharmaceutical company patient assistance programs for those who qualify. Free transportation and translation services are also available for those who need them. In addition, we offer assistance with case management such as enrollment in health insurance from the Affordable Care Act (“Obamacare”), enrollment in Medicare, and Healthy Start prenatal services.