Referral Management Coordinator

Company: Concentra
Location: Plano
Posted on: May 13, 2022

Job Description:

Overview:
Do you want to use your problem solving skills and knowledge of customer service to help improve the health of America's workforce? At Concentra, we serve more than 500 medical centers and 130 onsite clinics nationwide. Concentra colleagues remain fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner. We do this by putting all customers first. -

Responsibilities:
Position SummaryThe Referral Management Coordinator maintains high standards for quality and an exceptional patient experience in accordance with Concentra's policies, procedures and applicable regulations. The Referral Management Coordinator processes referrals requests and authorizations while working closely with physicians, employers and payors. Customer services is a top priority in order to achieve a positive impact on the cost and quality of care rendered to injured employees.The Details

• First point of escalation for all case related issues requiring guidance
• Responsible for daily completion of assigned patient referrals, while meeting production requirements
• Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market
• Obtains authorization for Specialist referrals and schedules appointments accordingly
• Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable
• Provides all necessary information such as medical records, prescriptions, etc. to payor
• Communicates with stakeholders, payor, employer, and patient as appropriate
• Records all appropriate information via OA/CR module of OccuSource per Concentra policy
• Builds relationships with provider, employer and payor communities
• Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor
• Handles calls according to the call guidelines of the department
• Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions
• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. -
  
  Qualifications:
  Education/Credentials
  • High school diploma or GED equivalent
  • Associated Degree from an accredited college preferredJob-Related Experience
    • Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)
    • Experience with Worker's Compensation preferred
    • Proficiency with scheduling/insurance verification softwareJob-Related Skills/Competencies
      • Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
      • The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
      • Familiarity with Microsoft Excel, Outlook, Word
      • Excellent communication skills and ability to communicate (both written and orally) effectively with colleagues at all levels of the organization
      • Must display proper business etiquette and be skilled in the arts of diplomacy and tact
      • Excellent time management skills including the ability to multitask and prioritize in a fast-paced environment
      • Ability to build and maintain productive business relationships
      • Exemplary ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
      • Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
      • Excellent writing and documentation skills
      • Strong attention to detail
      • Ability to work independently
      • Ability to handle special projects
      • Ability to handle multiple tasks, projects, duties, and priorities, when assigned
        
        Additional Data:
        Employee Benefits
        • 401(k) Retirement Plan with Employer Match
        • Medical, Vision, Prescription, Telehealth, & Dental Plans
        • Life & Disability Insurance
        • Paid Time Off & Extended Illness Days Offered
        • Colleague Referral Bonus Program
        • Tuition Reimbursement
        • Commuter Benefits
        • Dependent Care Spending Account
        • Employee DiscountsThis job requires access to confidential and critical information, requiring ongoing discretion and secure information management.We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. -Concentra is an equal opportunity employer, including disability/veterans -

Keywords: Concentra, Plano , Referral Management Coordinator, Executive , Plano, Texas