Overview
Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.
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 Summary
The 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.
Physical Requirements:
Must be a current Texas Resident
Must remain a Texas Resident during the duration of employement within the Referral Department
Must be able and willing to travel to a local Concentra to complete new hire orientation
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 preferred
Job-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 software
Job-Related Skills/Competencies
Concentra Core Competenciesof 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 BonusProgram
Tuition Reimbursement
Commuter Benefits
Dependent Care SpendingAccount
Employee Discounts
This 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
Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.
Originally posted on Himalayas