Employment Type:
Full time
Shift:
Day Shift
Description:
POSITION DESCRIPTION:
The Referral Coordinator Supervisor (RCS) is a strategic business partner working directly with assigned Program Manager to develop and implement short and long term goals, while assisting in managing day-to-day operations of the Referral Coordinator team. The RCS provides leadership and supervises the referral coordinator team for the Primary Care Division of the PPSC. Evaluates and manages all aspects of the Referral Coordinator team within the PPSC Divisions as it relates to finance, staffing, goals, performance, data collection and evaluation. The RCS will help develop and maintain productive, professional relationships with all of the key partners within the organization, division, providers, IHA and Trinity partners and staff.
ESSENTIAL JOB FUNCTIONS:
This position is knowledgeable and proficient in performing all Essential Functions in the Referral Coordinator job description, as well as the following Referral Coordinator Supervisor Essential Functions outlined below.
Administrative and Supervision Responsibilities
Works in partnership with assigned Division Leadership toward development of long-term and short-term service performance goals, growth opportunities and ensuring positive financial performance of the PPSC. In conjunction with the Program Manager, acts as a liaison between the PPSC Referral team and assigned division practices and other leadership teams. Supervises day-to-day operations of PPSC referral staff and services provided to ensure efficient, fiscally responsible and customer responsive operations. This includes monitoring of staff competencies, hiring of new staff, orientation of new assignments, conducting annual performance appraisal/merit consideration and promotions, and the utilization of performance resolution process, when needed. Maintains teamwork environment and a high level of employee morale. Works with the Program Manager and Division Leadership with developing goals and objectives for the team. Ensures that all staff are adequately trained to effectively perform their required responsibilities and provided with an overview of the PPSC performance goals and objectives through regular communications. Provides team members additional training, if needed. Effectively organizes training materials for new employees. Performs quality reviews on staff work and recorded telephone calls. Manages PPSC referral call data and phone data reports. Assists the Program Manager in the development and maintenance of the PPSC Referral Scorecard to show performance for all referral staff. Works 1:1 with PPSC leadership and team members to ensure quality of work. Ensures efficient and effective scheduling for the PPSC Referral Coordinator team and maintains Time & Attendance program. Coordinates timekeeping and time-off requests and maintains appropriate staffing at all times. Fills in as a referral coordinator, when needed.
Communications Responsibilities - Works respectfully and cooperatively with management staff, patients and vendors; handles escalated patient and staff issues, as needed.
Manages all internal and external complaints, manages compliance log and compiles data to provide monthly reports. Manages more complex patient calls or insurance issues. Provides ongoing communication to staff and leadership regarding pertinent authorization issues. Provides ongoing communication to staff and leadership regarding pertinent insurance items, EMR items, workflow changes, and daily communication updates as needed.
Continuous Improvement Responsibilities
Participates in process and procedure development. Works collaboratively with the PPSC leadership team to improve PPSC services, additional services and achieve PPSC goals. Oversees tasks that optimize workflow; provides suggestions to continually improve processes and the Customer Experience. Will oversee that all referral authorizations sent to the team are accurately obtained in a timely manner, as well as, responsible for developing and implementing processes that enhance the efficiency and effectiveness of the referral authorization program. Responsible for reviewing, submitting, monitoring and responding to issues regarding referral authorizations for IHA patients.
Other Responsibilities
Assumes all Referral Coordinator responsibilities, as needed. Attends required internal and external meetings, performs other administrative support tasks. Performs other duties, as assigned.
ORGANIZATIONAL EXPECTATIONS:
Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the mission and values of Trinity Health Medical Group. Must be able to work effectively as a member of the Referral Coordinator team. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management. Successfully completes all relevant organizational training and adheres to Trinity Health Medical Group standard of care as outlined in the Trinity Health Code of Conduct. Maintains knowledge of and complies with Trinity Health Medical Group standards, policies and procedures. Maintains general knowledge of Trinity Health Medical Group office services and in the use of all relevant office equipment, computer and manual systems. Maintains strict confidentiality in compliance with Trinity Health Medical Group and HIPAA guidelines. Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences. Uses resources efficiently. If applicable, responsible for ongoing professional development - maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.
MEASURED BY:
Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.
ESSENTIAL QUALIFICATIONS:
EDUCATION: Bachelor's degree or an equivalent combination of education and professional experience.
CREDENTIALS/LICENSURE: None
MINIMUM EXPERIENCE: Minimum of 3 years' experience with insurance referrals, prior authorization or other relevant medical office experience; experience in a supervisory capacity strongly preferred.
POSITION REQUIREMENTS (ABILITIES & SKILLS):
Ability to effectively supervise and manage functional area within the PPSC, providing feedback and guidance to staff. Demonstrated ability to administer a comprehensive training program for new and existing PPSC staff. Knowledge of billing and managed care department services and organizational policies related to position responsibilities. Knowledgeable in medical terminology related to position responsibilities. Ability to perform mathematical calculations needed during the course of performing basic job duties. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Mitel Connect, EPIC, email, e-learning, intranet, Microsoft Word and Excel, and computer navigation. Ability to use other software as required while performing the essential functions of the job. Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to speak before groups of people, either in-person or virtually. Ability to work collaboratively in a team-oriented environment; displays courteous and friendly demeanor. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, patients, family members, insurance carriers, vendors, external customers and community groups. Ability to cross-train in other areas of department in order to achieve smooth flow of all operations. Good organizational and time management skills to effectively juggle multiple priorities and time constraints. Ability to exercise sound judgement and problem-solving skills, specifically as it relates to resolving patient call issues. Ability to handle patient and organizational information in a confidential manner. Knowledge of the compliance aspects of clinical care and patient privacy and best practices in medical office department operations. Successful completion of IHA competency-based program within introductory and training period.
MINIMUM PHYSICAL EXPECTATIONS:
Physical activity that often requires keyboarding, phone work and charting. Physical activity that often requires extensive time working on a computer. Physical activity that often requires walking, standing, bending, stooping, reaching, climbing, kneeling and/or twisting. Physical activity that sometimes requires lifting, pushing and/or pulling up to 20 lbs. Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.
MINIMUM ENVIRONMENTAL EXPECTATIONS:
This job operates in a typical office environment which involves frequent interruptions and significant interaction with people which can be stressful at times.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.