GENERAL OVERVIEW:
This job facilitates and monitors the referral workflow from the acute care outpatient setting to home. The staff works directly with the physician practices, Account Executives and skilled facilities to coordinate the patient’s post-acute care needs. The incumbent works to complete their work in an effective, efficient, accurate, and timely manner to assure compliance with regulations. The incumbent requires strong computer and database management skills. It also calls for flexibility, excellent interpersonal skills and the ability to work well with all levels of internal management and staff, as well as outside customers and vendors. This job can be a career ladder job to senior and lead positions within the AHN Referral Center. Serves as a coordinator for patients and medical facilities into the post-acute care network as part of the AHN Healthcare at Home program. Assists with the coordination of medical care services that support the individual's continued recovery from illness or disability by placing the referrals and routing them to the appropriate post-acute care services and facilities. Many patients require continued medical care, either at home or in a specialized facility -- the representative facilitates care coordination between hospitals, outpatient physician offices, and ancillary departments.
ESSENTIAL RESPONSIBILITIES
Places referrals by data entry using an Allscripts based program in a timely manner. (10%)Enters patient information accurately into the system. (10%)Verifies and enters into a computer database patients' demographic information. (10%)Displays the ability to transcribe physician orders in order to properly enter and submit to the post-acute care facility. (10%)Works cooperatively with all parties in the coordination of patient care. (10%)Places and routes the referral for Home Medical Equipment, Home Health, Home Infusion, Palliative Care, Hospice, and placement into Skilled Nursing Facility, or Rehabilitation Center. (5%)Applies a quality control method by ensuring efficient and correct communication between care providers as well as delivery of product/service for patient satisfaction by identifying problems or opportunities for service and taking appropriate action to address their concerns. (5%)Escalates patient concerns or issues to immediate Supervisor. (5%)Answers consumer inquiries via telephone in regards to the Healthcare at Home program and its services. (5%)Referral acceptance -- organize, track, and build a complete medical record for appropriate patient transition to home and post-acute providers; obtains missing information, including all requirements to support care transition, initiation of service. (5%)Referral processing -- responsible for completing the transition of care via established systems and processes (Epic, Allscripts ECIN,Rightfax,Email, etc.). (5%)Education – Interact with clinicians in assistance with EPIC home care orders. (5%)Communication and reporting -- complete and process paperwork and enter notes promptly and accurately; manage and create general correspondences, memos in order to package referrals and medical records in support of a smooth and effective transition of care. (5%)Build and maintain relationships with post-acute and Hospital/network partners for the benefit of patients, families, and the health care team. (5%)Other duties as assigned or requested.5%QUALIFICATIONS:
Minimum
High School / GED1 year in a Healthcare call center1 year of Customer Service
Preferred
Clinical or medical backgroundData entryDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice