SUMMARY:

Coordination of Routine Referrals would be managed centrally to develop a dedicated, trained staff to manage referrals. This would better prepare patients for visit with specialist. Processing referrals would occur within 48 hours and health care cost reductions by directing patients in “In-Network” Providers. The position would help establish and maintain a preferred provider list, standardize patient centric workflow. Develops payer relationships to facilitate prior authorizations, standardize referral content and attachments. Position will help to reduce duplicate or unnecessary tests, prevent delayed diagnosis or treatment, minimize lost referrals and the access backlog.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Consistently applies the Brown Medicine values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Medicine mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Medicine Compliance Program and Code of Conduct.

BASIC KNOWLEDGE:

• Manage Referral beans in eCW for all sites, both Primary and Specialty Care

• Ensure Referral Request form is completed

• Acquire prior authorization for referrals as needed

• Ensure Referral is received and reviewed

1. Accepted with confirmation of appointment

• Declined or redirected (not needed, wrong specialty, lack of availability)

3.Patient defers making appointment, declines or cannot be reached (if Specialty is making the appointment)

• Schedule referral appointment for patient if not done directly

• Communicate with patient regarding referral appointment provider, time, location, what to expect and what to bring to appointment.

• Track referral response

• Document secondary referrals if indicated

• Attach/Scan Consult Note(s) to medical record

• Close referral when completed

EXPERIENCE:

• Minimum 3-5 years experience in a medical office setting

• E-clinical experience preferred

• 1-3 years experience with referrals

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

Conditions common to a clinical practice environment including potential exposure to communicable diseases, medicinal preparations and hazardous materials. Involves frequent contact with patients. Work may be stressful at times. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

INDEPENDENT ACTION:

Incumbent functions independently within the guidelines established by the policies and procedures of organization.

SUPERVISORY RESPONSIBILITY:

None.

EOE/F/M/Vet/Disabled