Referral Coordinator Clinic Services 24 hours Days

MetroWest Medical Center is the largest community health care system between Worcester and Boston. MetroWest Medical Center is committed to providing high quality, comprehensive care, at a location close to home. The 307-bed regional healthcare system includes Framingham Union Hospital, Leonard Morse Hospital in Natick and the MetroWest Wellness Center. MetroWest Medical Center has been named to the 2019 America’s 100 Best Hospitals List by Healthgrades. We are seeking a part-time Referral Coordinator, 24 hours per week, work hours Monday, Wednesday, and Friday, 9:00 AM - 5:30 PM.

GENERAL SUMMARY: Responsible for ensuring timely appointments are made with specialists or PCP’s and for processing all insurance referrals as needed. The Appointment and Referral Coordinator will follow the AHO referral guidelines and work with the PCP or the staff and the patient to help direct care, when medically appropriate, to a specialist with the AHO network and to MetroWest services.

PRINCIPAL DUTIES AND RESPONSIBILITIES:
Provide exceptional customer service to patients and office staff of the referring and receiving physicians.
ensure that a timely appointment is made with the receiving physician office and that communication flows smoothly between physicians and patients.
Process insurance authorizations electronically whenever possible. Process paper referrals for those insurance plans that do not have electronic capabilities.
Confirm eligibility of the member being referred.
Follow established AHO guidelines regarding AHO referrals; including pending referral for review by PCP or appropriate medical director and informing patient of the policies and protocols. Adapt to changes in guidelines if modified.
Communicate with primary care physician’s office to discuss possible re-direction of out of AHO referrals utilizing the method approved by the physician.
Communicates effectively with manager, co-workers and patients.
Performs all duties in an independent manner using appropriate judgment in referring problems and questions to the supervisor.
Assist with the daily operations of the AHO as needed, including help with mailings.
Completes all other job duties as assigned by supervisor.

Onboarding Process: Please be advised that candidates must successfully complete a background check and pre-employment health screening which includes a drug screen.

KNOWLEDGE, EXPERIENCE AND OTHER JOB REQUIREMENTS:
High School graduate or equivalent education required.
Must have a minimum of four years of experience working in a medical office setting.
One to three years health care experience either in the areas of patient registration or physician office.
Knowledge of hospital and medical terminology. Experience with hospital information systems. Excellent Customer Service skills. Knowledge and skill with Microsoft office.