Su Clinica Referral Clerk in Harlingen, Texas
Responsibility is to process all medical referrals in accordance to SCF’s referral policies and procedures that are essential in carrying out the patients’ health care plan.
Will perform all duties which involve interaction with a patient in a manner which ensures the patient has a pleasant and satisfactory experience.
All interactions with the patients will be in adherence to the PCMH principles, policies, and procedures.
Patient Communication: Inform patient of the percentage SCF will pay and what the patient will be responsible to pay, if insured deductibles are discussed. Instruct patient of the appropriate preparation, as indicted by the appointment.
Manages Appointments: Contact appropriate consultant’s office and arranges an appointment for the patient.
Obtains prior authorization for services, as needed. Notifies patient of schedule appointment date and time.
Team Communication: Consult with referring physician for appropriate follow up care. Approaches patient care as a team involving clinical and non-clinical staff (example, Physicians, mid-levels, educators, appointments staff) to achieve patient care objectives, as needed. Referral Clerk (RC) will attend meetings as required. RC adheres to all HIPAA regulations in and outside of the Clinic. Communicates patient information as requested to enhance patient services.
Management of Documentation: Utilize Centricity Physician Office referral process (EMR) to process all assigned referrals. Convert daily doctor flags to referrals into patient chart. Verify insurance coverage for patient. Obtain authorization from insurance companies, Medicare, Medicaid PCCM in order for patient to attend their appointment. Review and complete all invoices with a “referral stamp” and submits to the Finance Office for payment. Track patient’s appointments and confirms if patient kept their appointment. Submit quick text to Medical Records indicating patient kept appointment. Referral Clerk files, copies, and faxes medical referrals, as needed.
Demonstrates Safe and Professional Conduct: Maintains a friendly and safe environment for self and others. Refrains from texting and speaking on cell phone while on duty. Will maintain the phone on mute to avoid hearing the ringing of personal cell phones. Refrains from informal communications with patients and others. Attends work on a regular and predictable schedule in accordance with clinic leave policy and performs other duties assigned.
High school or GED. Must have a minimum of 1 year work experience in appointments, obtain prior authorization, registration or customer service answering telephone, providing information to patients in a healthcare setting or social service agency with knowledge of medical terminology. Must be bilingual English/Spanish