Referral Coordinator

Updated: about 2 months ago

23-May-2024

University Health Services

65835BR


Job Summary

Serves as liaison between patients and providers to schedule diagnostic tests and specialty consultations at outside organizations (prior authorization as needed) and in-house specialty appointments. Obtains date of service and follows up with visit results. Assists patients with tracking referral status in the electronic system. Works collaboratively with Member Services and Care Coordination departments. Office responsibilities include data entry and coordination of mailings. Collaborates with satellite and specialty offices in processing referrals.

DUTIES AND RESPONSIBILITIES: 

  • Knowledgeably articulates insurance limitations to patients. 
  • Tracks referral status in the electronic system and ensures documentation of referral visits is available for PCP follow-up or upon request. 
  • Schedules diagnostic tests and specialty consultations at outside organizations. 
  • Assists patients with scheduling in-house specialty appointments. 
  • Assists patients by providing directions to outside facilities. 
  • Communicates with outside referral services by telephone, fax, and e-mail. 
  • Serves as liaison between patient and inside/outside providers. 
  • Communicates referral appointment information to patient and provider. 
  • Keeps pre-testing instructions updated from referral organizations. 
  • Generate reports as requested. 
  • Work collaboratively with Member Services and Care Coordination department. 
  • Enters referral into “BlueLinks.” 
  • Enters patient information into “AIM” to obtain prior approvals. 
  • Initiates process for over 90 days and out of network referral requests in coordination with Member Services. 

GENERAL OFFICE: 

  • As a member of the clinical care team, assures the safe and satisfactory care of patients. 
  • Opens and closes the clinic according to written protocol. 
  • Collects and records all payments including insurance co-payments, inoculations, fee for service, and medical equipment. 
  • Schedules patient appointments utilizing all functions of the appointment system. 
  • Completes all the necessary information in scheduling patient appointments.  
  • Handles all emergency phone calls appropriately, efficiently, and according to emergency protocol.  
  • Responds appropriately to patient requests for medical record information. 
  • Types and sends letters. 
  • Assists patients by providing directions, escorting, transporting, and ensuring their comfort and safety. 
  • Sets priorities in organizing activities for the day. 
  • Demonstrates flexibility when unexpected changes in assignment occur. 
  • Identifies own learning needs and requests assistance from others when needed. 
  • Documents care provided using appropriate forms. 
  • Communicates to other staff members/group leader and/or clinician prior to leaving unit for break or lunch periods and prior to leaving for the day in order to ensure appropriate unit coverage. 
  • Demonstrates the ability to identify and respond to potential life threatening situations during telephone encounters. 
  • Demonstrates universal precautions in all care delivery. 
  • Carries out proper procedure for reporting faulty equipment.  
  • Prepares medical records ensuring that confidentiality is maintained. 

Position Description

•    Knowledgeably articulates insurance limitations to patients.
•    Tracks referral status in the electronic system and ensures documentation of referral visits is available for PCP follow-up or upon request.
•    Schedules diagnostic tests and specialty consultations at outside organizations.
•    Assists patients with scheduling in-house specialty appointments.
•    Assists patients by providing directions to outside facilities.
•    Communicates with outside referral services by telephone, fax, and e-mail.
•    Serves as liaison between patient and inside/outside providers.
•    Communicates referral appointment information to patient and provider.
•    Keeps pre-testing instructions updated from referral organizations.
•    Generate reports as requested.
•    Work collaboratively with Member Services and Care Coordination department.
•    Enters referral into “BlueLinks.”
•    Enters patient information into “AIM” to obtain prior approvals.
•    Initiates process for over 90 days and out of network referral requests in coordination with Member Services.

GENERAL OFFICE:
•    As a member of the clinical care team, assures the safe and satisfactory care of patients.
•    Opens and closes the clinic according to written protocol.
•    Collects and records all payments including insurance co-payments, inoculations, fee for service, and medical equipment.
•    Schedules patient appointments utilizing all functions of the appointment system.
•    Completes all the necessary information in scheduling patient appointments.
•    Handles all emergency phone calls appropriately, efficiently, and according to emergency protocol.
•    Responds appropriately to patient requests for medical record information.
•    Types and sends letters.
•    Assists patients by providing directions, escorting, transporting, and ensuring their comfort and safety.
•    Sets priorities in organizing activities for the day.
•    Demonstrates flexibility when unexpected changes in assignment occur.
•    Identifies own learning needs and requests assistance from others when needed.
•    Documents care provided using appropriate forms.
•    Communicates to other staff members/group leader and/or clinician prior to leaving unit for break or lunch periods and prior to leaving for the day in order to ensure appropriate unit coverage.
•    Demonstrates the ability to identify and respond to potential life threatening situations during telephone encounters.
•    Demonstrates universal precautions in all care delivery.
•    Carries out proper procedure for reporting faulty equipment.
•    Prepares medical records ensuring that confidentiality is maintained.


Basic Qualifications

High school diploma or equivalent. 


Additional Qualifications and Skills

  • Medical secretary/patient service experience.
  • Typing and/or computer skills, telephone skills, and multi-lingual.  
  • Excellent interpersonal, customer service and organizational skills.  
  • Experience with insurance products and obtaining prior authorization.

Physical Requirements

All Harvard University Health Services (HUHS) staff and staff affiliates are considered Health Care Workers and as a condition of employment must provide documentation of the following:  

  • Letter of good health from your personal health care provider.  
  • TB skin test (within past 3 months) or, if known skin test positive, documentation of previous chest x-ray, information about any past treatment.  
  • Documentation of immunity (positive antibody titers) for Measles, Mumps, Rubella and Varicella.  
  • Proof of appropriate past immunization for Measles, Mumps, Rubella and Varicella. 
  • Hepatitis B vaccine series – required for staff with possible exposure to blood or blood borne pathogens.  
  • A current Flu vaccine (this season) and Covid vaccines to include the Primary series and Bivalent Booster.  

The required medical documentation/medical clearances can often be obtained by contacting your Pediatrician, PCP, medical provider. Titers, TB Skin testing can be performed by appointment at Occupational Health facilities. 

HUHS continues to place the highest priority on the health, safety and wellbeing of its faculty, staff and students, as well as the wider community. Being up to date with COVID vaccination, annual flu vaccination and other required medical vaccinations and documentation are required as a condition of employment at HUHS. You may claim exemption from the vaccine requirements for medical or religious reasons. 


Working Conditions

The University requires all Harvard community members to be fully vaccinated against COVID-19 and remain up to date with COVID-19 vaccine boosters, as detailed in Harvard’s Vaccine & Booster Requirements. Individuals may claim exemption from the vaccine requirement for medical or religious reasons. More information regarding the University’s COVID vaccination requirement, exemptions, and verification of vaccination status may be found at the University’s “COVID-19 Vaccine Information” webpage: http://www.harvard.edu/coronavirus/covid-19-vaccine-information/.


Additional Information

PROFESSIONAL/TEAM WORKPLACE ACCOUNTABILITY: 

  • Maintains patient confidentiality. 
  • Demonstrates respect in all interpersonal interactions. 
  • Works collaboratively with all members of the health care team. 
  • Performs all personal business away from patients and all work areas. 
  • Identifies own learning needs and requests assistance from others when needed. 
  • Adheres to regulatory guidelines i.e. AAAHC, DPH, OSHA, etc. 
  • Adheres to departmental and unit specific policies, procedures, guidelines and protocols. 
  • Participates in orientation of new staff members. 
  • Attends staff meetings and educational offerings required by the department. 
  • Provides coverage to other areas as necessary. 
  • Performs related duties as required. 
  • Plans for time off in advance and according to clinic policy. 
  • Provides proper notification for absences or tardiness. 
  • Is punctual and prepared for duties at start of shift. 
  • Is reliable and dependable in coming to work. 
  • Is flexible and responsive to the needs of the clinic and department in regard to work schedule. 
  • Demonstrates caring and willingness to help in all interactions. 
  • Cooperates and complies with goals/projects of clinic and department. 
  • Utilizes time productively. 
  • Maintains professional conduct and appearance. 
  • Performs other duties and responsibilities as needed. 

AGE SPECIFIC COMPETENCIES:
Provides care to the adolescent through utilization of the following:
a)     Supplements explanations with reasons for “why?”
b)     Encourages questions regarding fears.
c)     Allows adolescent to maintain control.
d)     Realizes there may be resistance.
e)     Provides privacy.
Provides care to the adult patient through utilization of the following:
a)    Recognizes anxiety regarding potential chances in lifestyle resulting from illness.
b)    Provides education based on learning needs.
Provides care to the geriatric patient through utilization of the following:
a)     Speaks distinctly due to loss of ability to discriminate sounds.
b)     Slows pace of explanation due to slowed cognitive functioning.
c)     Maintains a safe environment based upon physical and psychological function.

COMPLIANCE:
•    Adheres to the expectations and professional responsibilities of the department.
•    Employs the standards, practices, and procedures of the department.
•    Completes and complies with HUHS training requirements including HIPAA Privacy and Security.
•    Reports non-compliance incidents to the supervisor, manager, and/or Compliance Officer.


Work Format Details

This position is based primarily on-campus, in Massachusetts. This may include in-person during emergency situations (if applicable). Additional details will be discussed during the interview process. Certain visa types may limit work location. Individuals must meet work location sponsorship requirements prior to employment.


About Us

Harvard University Health Services (HUHS) is a campus-based health care organization devoted exclusively to members of the Harvard community. Our work includes multi-specialty ambulatory medical care, behavioral and mental health services, and campus public health. HUHS also manages two self-funded health insurance plans, the Harvard University Group Health Plan (HUGHP, for university employees and dependents) and the Student Health Insurance Plan (SHIP, for students and dependents). 


Benefits

We invite you to visit Harvard's Total Rewards website (https://hr.harvard.edu/totalrewards ) to learn more about our outstanding benefits package, which may include:

  • Paid Time Off: 3-4 weeks of accrued vacation time per year (3 weeks for support staff and 4 weeks for administrative/professional staff), 12 accrued sick days per year, 12.5 holidays plus a Winter Recess in December/January, 3 personal days per year (prorated based on date of hire), and up to 12 weeks of paid leave for new parents who are primary care givers.
  • Health and Welfare: Comprehensive medical, dental, and vision benefits, disability and life insurance programs, along with voluntary benefits. Most coverage begins as of your start date.
  • Work/Life and Wellness: Child and elder/adult care resources including on campus childcare centers, Employee Assistance Program, and wellness programs related to stress management, nutrition, meditation, and more.
  • Retirement: University-funded retirement plan with contributions from 5% to 15% of eligible compensation, based on age and earnings with full vesting after 3 years of service.
  • Tuition Assistance Program: Competitive program including $40 per class at the Harvard Extension School and reduced tuition through other participating Harvard graduate schools.
  • Tuition Reimbursement: Program that provides 75% to 90% reimbursement up to $5,250 per calendar year for eligible courses taken at other accredited institutions.
  • Professional Development: Programs and classes at little or no cost, including through the Harvard Center for Workplace Development and LinkedIn Learning.
  • Commuting and Transportation: Various commuter options handled through the Parking Office, including discounted parking, half-priced public transportation passes and pre-tax transit passes, biking benefits, and more.
  • Harvard Facilities Access, Discounts and Perks: Access to Harvard athletic and fitness facilities, libraries, campus events, credit union, and more, as well as discounts to various types of services (legal, financial, etc.) and cultural and leisure activities throughout metro-Boston.

Job Function

General Administration


Department Office Location

USA - MA - Cambridge


Job Code

403027 Staff Assistant II-Specialist


Department

Internal Medicine


Union

55 - Hvd Union Cler & Tech Workers


Pre-Employment Screening

Criminal, Identity


Schedule

Monday - Friday: 8 hours each day 

Total: 40 hours per week 


Commitment to Equity, Diversity, Inclusion, and Belonging

Harvard University Health Services is committed to fostering a diverse, inclusive, and equitable workplace in which all employees feel valued and have a sense of belonging. These principles are integral to our work and are at the core of who we are. We actively seek applicants with demonstrated commitment and/or experience promoting and fostering a working and learning environment that is supportive of individuals from diverse backgrounds. We welcome, respect, and embrace individuals from varied backgrounds, cultures, races, identities, life experiences, perspectives, abilities, beliefs, and values. 


EEO Statement

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, gender identity, sexual orientation, pregnancy and pregnancy-related conditions, or any other characteristic protected by law.



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