Referral Coordinator II

Description

Position Overview

The Referral Coordinator II is responsible for managing the specialty referral process when a provider identifies a higher level of care is needed. This role plays a critical part in facilitating seamless transitions of care for patients in need of specialty care, ensuring they receive appropriate support and resources throughout their healthcare journey.

Reporting to the Manager of Patient Experience, the position is responsible for coordinating referrals for complex cases that require careful attention and follow-up, while also engaging directly with patients to address challenges and support communication with specialists across the North Shore region.

The Organization

North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the surrounding communities with comprehensive and culturally sensitive care. With a strong commitment to excellence, NSCH provides:

• •Comprehensive primary care.
• •Dental services.
• •Behavioral health care.
• •Care management.
• •Pharmacy services.
• •Substance abuse disorder treatment.
• •Nurse care management.
• •Insurance enrollment assistance.

NSCH operates service sites at Gloucester, Peabody, and Salem Family Health Centers, ensuring convenient access to care. Additionally, NSCH extends its reach through school-based health centers within the Salem and Peabody School Districts. NSCH collaborates with Bentley Academy, Collins Middle School, Horace Mann School, Bates Elementary School, and the Peabody Learning Academy for behavioral health services.

As a community-based safety net healthcare provider, NSCH actively encourages diversity and welcomes staff members who reflect the rich tapestry of our communities. We highly value the contributions of our team members and offer a wide range of perks and comprehensive benefits. These include health and wellness benefits, tuition reimbursement, loan forgiveness opportunities, and other appealing benefits.

We believe in supporting our employees from day one, and all eligible staff members can take advantage of these benefits right from the start of their employment at NSCH. We aim to foster a supportive and rewarding environment that empowers our team members to provide exceptional care to our communities.

Mission

North Shore Community Health’s mission is to build healthy communities by providing exceptional care to all.

Vision

Healthy People | Vibrant Communities

Values

Accountability

We take our responsibility to ourselves, each other, and the NSCH Community very seriously. We understand our individual roles, and positions of power with respect to how others perceive our roles and actions. We hold ourselves accountable when we make mistakes–acknowledging the error, owning it, taking corrective actions, and moving forward. We follow through on what we commit or resolve to do.

Integrity

Integrity is the foundation of healthy relationships. We are committed to the highest ethical standards: honesty, fairness, respectfulness, and trustworthiness. We are honorable and respectful in dealings with others, and we strive to deal honestly, fairly, and in a respectful, ethical, and trustworthy manner when in agreement or disagreement.

Empathy

Empathy is a deep appreciation for another’s situation and point of view, which is the basis for the golden rule and our intrinsic sense of justice. We strive to bring empathy into our interactions with each other and with our patients.

Courage

We see courage as the strength of character to stand up for our convictions and belief system. To have courage is to have the fortitude to take risks and to extend one’s behaviors, actions, and thoughts beyond one’s comfort zone. We appreciate that courage is often required to compromise. Courage is a state of mind to face adverse, difficult, and challenging situations with confidence and positive energy.

Respect

NSCH holds its patients in the highest regard. We provide care that is respectful of and responsive to individual patient needs and values. We take the time to listen to concerns, understand what is important, and provide appropriate solutions and care. We do this through coordination and integration of care, collaboration, and teamwork.

Commitment

NSCH is committed to the health and well-being of its community, patients, and staff. We demonstrate this commitment by constantly striving to align our actions with our mission, vision, and values.

EEO Statement:

We, North Shore Community Health (NSCH), are an equal employment opportunity employer. Our goal is to have a diverse workforce representative of all people, at all job levels, in the organization. We do not and will not make any personnel decisions (like recruiting, hiring, job assignments, and promotions) based on age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity, gender expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law.

Essential Duties and Responsibilities

1. Oversee the referral coordination to specialty services.

2. Coordinate appointments for specialty services as requested by the ordering provider.

3. Collect proper supporting data for each referral before sending it to the specialist.

4. Provide feedback to the manager and/or care team.

5. Be the point of contact for hospitals and specialty offices.

6. Respond to inquiries as to the status of the referral by assessing the request and evaluating the circumstances to provide the correct information.

7. Verify insurance and obtain prior authorizations with insurance companies via phone, in writing, or electronically.

8. Inform patient of appointment date, time, and required documentation needed prior to appointment.

9. Provide patient instructions prior to appointment.

10. Review work queues on a weekly basis to ensure the patient kept his/her appointment.

11. Open and review flags regarding consults

12. Document entry in EMR as a non-billable encounter and enter the specialty appointment in the referral log.

13. Log any no-shows and flag the referring physician for follow-up with the patient.

14. Direct patient to outside resources when needed as requested by primary care physician.

15. Keep patient information private and communicate professionally with everyone involved in the referral process.

Requirements

Required Skills and Abilities:

1. Demonstrated reliability, good attendance, and positive attitude

2. Detail-oriented with strong organizational and follow-up skills

3. Ability to utilize advanced reporting tools and data to inform decision-making and improve outcomes

4. Strong problem-solving skills to manage complex patient needs and referrals

5. Warm and professional telephone manner with patience and good memory

6. Ability to multi-task and work effectively in a fast-paced environment

7. Courteous, efficient, and effective communication with patients, specialists, and colleagues

8. Strong interpersonal and communication skills, with the ability to mentor junior staff

9. Competency with Microsoft Office Suite; proficiency with EPIC and other healthcare technology platforms is a plus

10. Ability to maintain strict adherence to confidentiality policies

11. Commitment to incorporating North Shore Community Health’s mission and values into daily activities

12. Flexibility regarding work assignments and patient needs

Education & Experience

1. High School diploma or equivalent required; associate degree or additional training in healthcare administration or related field preferred

2. Minimum of two (2) years of customer service experience, preferably in a medical setting; prior experience with referral coordination or patient navigation strongly preferred

3. Bilingual in Spanish/Portugu