all medical referrals in accordance to SC referral policies and
procedures that are essential in carrying out the patients’ health
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
Inform patient of the referral
recommendation by the physician and works with the patient
regarding dates for appointments and the importance of keeping the
appointment. If patient needs financial assistance, clerk will
refer to the Social Workers. Instruct patient of the
appropriate instructions, as indicted by the
Contact appropriate consultant’s
office and arranges an appointment for the patient.
prior authorization for services, as needed. Notifies patient
of schedule appointment date and time. Will conduct the
majority of the authorizations and teach other new referral clerks
how to conduct them. Will also serve as mentor to other new
referral clerks. Maintain positive and effective
communication with all referral clerks.
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.
Will assist the Director of Social Services in conducting
audits to make sure all referrals are addressed
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 Chief Financial Officer 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
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.
School or GED. Must
have a minimum of 1 year work experience scheduling 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. This position requires an initial N95
mask fit testing and annual test fitting thereafter unless there is
a significant change during the year that requires retesting prior
to the annual fit testing.