new haven, CT, 06532, USA
3 days ago
Referrals and Call Center Navigator
Fair Haven Community Health Care  FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at over 143,000 office visits in 21 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.” For 53 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients.  We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay. Job purpose To assist clinicians and patients in managing specialty and diagnostic referrals and schedule appointments and perform tasks in medical records.  When necessary navigates patients through the health care system from the initiation of the referral, to obtaining prior authorization, scheduling appointments and tracking and following up on results. Duties and responsibilities This hybrid position works both in the call center and referrals department as needed. Typical duties include but are not limited to: + Works in close partnership with the clinical teams to manage all aspects of external referrals and obtains prior authorization for referrals when necessary. + Makes appointments and any additional referral arrangements with patient referral sites. + Documents all aspects of the referrals process in the patient’s Electronic Health Record and communicates with referring clinicians when patients cannot be reached. + Educates patients related to requirements of referrals, referral sites/ locations and/or appointment specifics.  + Works to identify performance improvement needs and strategies for managing, tracking and following up on referrals. + Manages a system for follow up of referrals, by maintaining a searchable database. + Works with teams and individual providers to clarify access issues, or other barriers for particular referrals or groups of referrals. + Familiarizes self with and acts as an expert related to insurance practices and coverage or referrals by various payer sources. + Ensures patient confidentiality, and provides patients with needed information. + Schedule, utilize triage referral guidelines and script usage to assist patients who call into the call center. + Answer multi-line telephone system, screen and direct telephone inquires via EHR to the appropriate person in an efficient manner while utilizing  Call Center documented workflow. + Accurately acquire, confirm and input and update patient demographic information. . + Performs other necessary duties as required by FHCHC to achieve the goal of providing high quality services and primary health care. Qualifications High School diploma or GED is required.  An Associate’s degree is highly preferred. Minimum of one to two years relevant work experience in a high volume medical office and call center highly preferred.   Referrals experience preferred Electronic appointment scheduling and data entry experience required.  Exceptional phone etiquette incorporating strong communication, interpersonal and customer service skills a necessity.  Strong critical thinking and problem solving skills with the ability to work as a member of the team to serve patients is a must. Bilingual in English and Spanish is required. Direct Reports None                   OSHA Status Category III—Low Risk Position Generally works in an office environment with no exposure to bloodborne pathogens Physical requirements Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records, Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions. Manual Dexterity Required:  Ability to use a keyboard, telephone. American with Disabilities Requirements: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need. Powered by JazzHR
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