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Referral Specialist/Patient Support Services
Under general supervision of the Referral Coordination Supervisor, the Patient Support Specialist (PSS) staff member will support the goals and objectives of Union Heath Center (UHC). PSS staff will work cooperatively with all clinical and non-clinical staff, to develop procedures that enhance the Health Center’s team-based approach to patient-centered care. As an integral member of the health care team, PSS Staff will track laboratory/imaging tests and medical referrals and effectively communicate with the clinical team to process the referrals in a timely fashion. PSS staff will respond to requests for medical information on health center patients from providers and other authorized recipients outside of the health center.
- ESSENTIAL DUTIES AND RESPONSIBILITIES: Include the following and may include additional tasks as assigned.
Processing Medical Referrals
- Processes patient referrals for external procedures ordered by physicians in a timely manner; obtains precertification, if necessary.
- Establish and maintain relationships with external medical specialist and office staff to obtain necessary reports and/or medical records for patient’s Electronic Health Record (EHR).
- Schedule diagnostic testing and/or consultation appointment on behalf of the patients through office staff contacts as needed.
- Access the UHC PAS outlook mailbox to retrieve referral appointment date and times, and update the referral.
- Communicate upcoming appointments / missed appointments with patients via phone call or mail per UHC Policy and Procedure.
- Document notes and appointments dates on all referrals scheduled in the EHR as per UHC Policy and Procedure.
- Coordinate with the clinical team to address patient and family inquires regarding referrals.
- Utilize the internal “Indexing Client” system to scan reports, tests, and other pertinent medical documents as received for patients into the EHR following the UHC scanning matrix.
Quality Assurance Reporting
- Run referral reports, maintain ongoing tracking and outreach for referrals and audit information entered in the EHR as needed to ensure compliance with capturing necessary data.
- Assist with quality assurance activities and special projects as needed.
- Process Insurance authorizations / referrals and fax to appropriate external medical provider
- Scans all insurance approval/ denial request for referrals into EHR, following UHC scanning Matrix.
- Assists patients in securing information on insurance coverage for services not available within the center.
- Work with insurer on-site representative to identify co-payment costs for patients regarding referrals
- Complies with the Union Health Center’s policies & procedures related to privacy and security of identifiable patient information (PHI), as explained in HIPAA (Health Insurance Portability & Accountability Act)
- Complete all Workman’s Compensation requests as needed; Completing all paperwork: Electronic intake form, Employer letter, C4 form, update ‘Workman’s Compensation’ electronic spreadsheet and explaining the Workman’s Compensation Process to the patient.
- Attend assigned clinical team meetings to update the clinical staff on the referral process
- Handle telephone inquiries from patients, providers and insurance companies and documents all phone interactions utilizing a phone note in the EHR.
- Organizes and prioritizes workload based on competing priorities
- Assists with renewing patient eligibility for center services as per UHC eligibility process.
- Responds to requests for medical information from patients, providers, and other authorized individuals and organizations either manually or electronically, per policy, subject to patient consent for release of information and health Center policies and procedures.
- Ensures that requests for information are compliant with requirements of the Health Insurance Portability & Accountability Act (HIPAA), New York State Department of Health regulations, and center policies and procedures.
- Maintains electronic correspondence disclosure log documenting requests for information and responses to those requests, whether manually or electronically, as outlined in Center policies.
- Prepares correspondence within the patient’s EHR to respond to requests for information, as needed.
- Scans and/or prints out electronic medical record documents from the patient’s chart relevant to the authorized requests for information.
- Receives and processes subpoenas including review of chart completion, removal of unrelated correspondence and coordination with Finance and Risk Management staff regarding billing information before forwarding documents to attorneys and/or the Court.
- QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. The Union Health Center will comply with applicable standards of the Americans with Disabilities Act.
EDUCATION, EXPERIENCE, & SKILLS
- High school diploma or equivalent required.
- Associates degree or minimum of 3 years of related work experience in health care setting preferred
- Language proficiency required in one of the inclusion languages of the organization: Bilingual preferred
- Basic understanding of health benefit plans of eligibility, benefits, and prior approval and reporting requirements
- Able to operate personal computers, photocopy machines, printers, fax machines and scanning equipment.
- Proficient in use of all computer systems and software, including the health center’s Electronic Health Records system and Microsoft Office products (Word, Excel, Outlook, etc.)
- Working understanding of medical terminology and CPT codes.
- Strong interpersonal, oral, written communication, and collaborative skills
- Excellent telephone skills and strong customer service focus
- Able to follow through with delegated tasks independently and in a team environment and meet established productivity standards
PLEASE SEND RESUME AND COVER LETTER TO Employment@unionhealthcenter.org
Medical Assistant – Bilingual Spanish
- ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Measures and/or records vital signs, allergies, weight, height and smoking status into the electronic medical record (EMR).
- Performs urine pregnancy test, peak flows, finger stick for glucose, monofilament foot exams and/or urine dipstick, if needed.
- Codes patient procedures into the EMR.
- Assists provider with refilling medication prescriptions and patient procedures as per Union Health Center (UHC) policies and procedures (P&P).
- Reviews EMR prior to scheduled appointments for completion of health maintenance recommendations, previous Pap smear, mammography, other radiographic studies and lab work. Updates flow sheet as per UHC P&P.
- Checks and stocks exam rooms with supplies. At the end of the work day, prepares exam rooms for the next work day.
- Sets up room for the provider.
- Communicates bi-directionally with greeter of patient’s arrival and/or appointment status.
- Escorts patient to the exam room. Initially assesses and prepares the patient for the provider.
- Reviews, confirms and updates the patient’s demographic data in the EMR registration document.
- Communicates with the provider and team.
- Assists the provider with translation, form completion and patient education, as needed.
- Updates the EMR as directed by the provider (medications, E&M coding).
- Schedules future appointments in the EMR and directs the patient to his/her next stop (lab, pharmacy, radiology, P.S.S.).
- Assists provider with visit confirmation/follow-up calls, preparing letters to patients or rescheduling appointments per UHC P&P. Makes reminder calls and generates correspondence per UHC P&P.
- Cleans and sterilizes instruments as needed.
- Answers telephones and documents clinical notes in the EMR per UHC P&P.
- Complete and sign notes in a timely manner.
- Completes electronic or paper referrals for patients.
- Collects information about walk-in patient’s clinical complaints and directs patient to the RN for triage, if necessary.
- Follows safety procedures and blood borne pathogen precautions as per UHC policies and procedures.
- Prepares materials for injections, nebulizer treatment, and in-office procedures as directed by the provider.
- Supports and reinforces policies re: patient care, infection control and safety.
- High school or Equivalency /GED Diploma and current Medical Assistant Registration (RMA) or Certification (CMA).
- Computer Literate.
- Language proficiency required in one of the target languages of the organization.
- Ability to communicate and work well with people at all levels; excellent team and “people” skills.
- Assist and maintain a strong working relationship with providers and professional members of the team.
- Strong interpersonal, oral and written communication skills.
- Initiates good judgment and ability to contribute in making decisions in a timely fashion.
- Actively seek out and support collaborative thinking and problem solving with others in the organization.
- Possess a professional appearance and presentation.