The Referral and Records Specialist assists in securing financial coverage and scheduling complex health-related appointments with specialty referral providers in diverse locations in Kitsap, Pierce, and King County. The position works collaboratively with the PRC Claims specialist to ensure coverage of medically necessary services for PRC-eligible patients.

Duties Include:

Referral Coordinator Primary Job Responsibilities:

• Schedules and confirms financial coverage for referrals for PRC-eligible patients for complex medical consultations with specialty providers.
• Multitasking referral requests from providers, incoming provider and patient phone calls, and referral providers' faxes.
• Ensures x-rays, laboratory data, consults, and treatment reports are obtained before consulting office visits and ensures that the needed reports are provided to the consulting provider.
• Tracks all out-of-office referrals and patient appointment compliance to meet Medicaid Managed Care guidelines. Referrals are tracked via phone, fax, and mailed-in consult reports.
• Obtains insurance approval and assists in determining PRC eligibility & obtaining purchase orders from PRC staff.
• Updates outside provider insurance eligibility criteria.
• Assists in scheduling patient transport with the CHR staff when needed.
• Remains in contact with patients regarding their referrals and provides information on the appointment date, time, location, insurance data needed, transportation arrangements, and any pre-visit instructions requested by the referral clinician.

Medical Record Clerk Responsibilities:

• Ensures the visit note is complete with a provider note and signature.      
• File completed visit notes in the proper location in the chart.
• Provide a copy of the visit note to billing.
• Archive inactive and deceased patients’ charts.
• Respond to requests for the release of Medical Records promptly.
• Ensure the patient signs an appropriate release.
• Release only specific records in the chart requested by the patient.
• Task faxed reports, medication requests, etc., to appropriate staff (i.e., triage nurse, medical providers).
• Fax medication refill orders, referrals, notes, or orders to outside providers as requested by providers.
• Scan reports, notes, labs, etc, as requested.

Remote Work:

• This position is not eligible for remote work.

Education and Certifications:

• GED or High School Diploma required.
• First Aid/CPR Certification required
• Naloxone training within 3 months of hire

Experience:

• Administration Experience: A minimum of 1 year of experience in a primary care Health Center
• Personal Computer Skills: Personal computer skills, including proficiency with Microsoft Office, are required. E-mail and Internet skills are also required.
• Medical Terminology: Knowledge of basic medical terminology is desired.
• Interpersonal Relationship Ability: Ability to interact with others professionally and compassionately, maintain confidentiality, and work well as a team member.

Physical Requirements:

• Regularly required to finger, handle, reach with hands and arms
• Frequently required to walk, sit, stand.
• Occasionally required to lift and move up to 25 pounds.
• Normal audio and visual acuity

Travel Requirements:

Local, Statewide, and out-of-state travel may be required.