Referral Management Coordinator - Remote Texas Only

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 service 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 employment within the Referral Department
• Must be able and willing to travel to a local Concentra to complete new hire orientation

Responsibilities

• 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

Qualifications

Education/Credentials

• High school diploma or GED equivalent
• Associate 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 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