Referral Coordinator (All BH Sites)

Job Objective: This position is responsible for for coordinating the intake and management of all behavioral health referrals received by Community Care of West Virginia. This position ensures referrals are processed accurately and efficiently, verifies patient eligibility, maintains referral workflows within the EHR, secures required consents and releases, and tracks referrals from receipt through assignment. The Referral Coordinator serves as the central point of contact for referral management to facilitate timely access to behavioral health services.

Responsibilities and Essential Duties:

• Receive and process all incoming behavioral health referrals from internal and external referral sources.
• Verify patient demographics, insurance eligibility, and required registration information.
• Enter all referrals accurately into the EHR electronic health record.
• Review referrals for completeness and obtain missing clinical documentation as needed.
• Obtain required Releases of Information (ROI), consents, and other authorization documents.
• Maintain and monitor the Behavioral Health Referral Buckets to ensure timely progression through each stage of the referral process.
• Track referral status from receipt through patient assignment.
• Coordinate with Referral Specialists, Assessment Clinicians, therapists, school personnel, medical providers, and outside agencies to facilitate patient placement.
• Maintain accurate documentation regarding referral status, patient contacts, and follow-up activities.
• Identify referral delays or barriers and escalate concerns to leadership as appropriate.
• Maintain strict confidentiality in accordance with HIPAA and organizational policies.
• Participate in departmental meetings and quality improvement initiatives.
• Assist with development and monitoring of referral workflow processes.
• Prepare referral reports and productivity metrics as requested.
• Perform additional duties as assigned.
• Daily Performance Metrics - Referral Coordinaor will monitor and report:
• Number of new referrals received.
• Number of referrals pending initial patient contact.
• Number of referrals pending assessment.
• Number of referrals awaiting therapist assignment.
• Average referral processing time.
• Referral dashboard accuracy and completion.

Patient Satisfaction:

• Demonstrate compassion, professionalism, and respect during every patient interaction.
• Maintain confidentiality and protect patient privacy at all times.
• Respond promptly to patient and referral source inquiries.
• Communicate clearly regarding referral status and next steps.
• Promote a positive patient experience through timely follow-up and coordination of services.
• Take ownership of patient concerns and work collaboratively to resolve issues

Teamwork:

• Work collaboratively with Behavioral Health providers, medical staff, school personnel, and administrative departments.
• Foster positive working relationships throughout the organization.
• Support coworkers during periods of increased referral volume.
• Demonstrate flexibility in adapting to changing organizational priorities.

Problem Solving:

• Exercise sound judgment when evaluating referrals and identifying barriers to care.
• Investigate referral issues and work collaboratively toward timely resolution.
• Identify workflow improvements that increase efficiency and patient access.
• Escalate high-risk or urgent referrals according to organizational protocols.
• Ensure compliance with regulatory, payer, and organizational requirements.

Productivity/ Efficiency:

• Maintain an organized referral workflow while managing multiple priorities.
• Meet established referral processing timelines.
• Demonstrate initiative in improving workflow efficiency.
• Maintain accurate and timely documentation.
• Utilize departmental downtime productively through training, organization, and quality improvement activities.

Great Benefits

• Paid Time Off (PTO)

• Paid Holidays

• Extended Sick Pay (ESP)

• Medical Health Insurance and Prescription Coverage

• Basic Life Insurance for Employee and Family

• Short-Term Disability

• Long-Term Disability

• 401(k) Voluntary Contribution Plan

• Health Reimbursement Account

• Employee Elected Voluntary Coverage for Employee and Family

• Life Insurance, Dental, Vision, Flexible Spending Account, Dependent Spending Account

• Discounted undergraduate & graduate rates at West Virginia Wesleyan College for employee and family

Adherence to Departmental Policies:

• Demonstrate knowledge and understanding of all policies and procedures and the ability to reference them from appropriate books and manuals.
• Maintain compliance with HIPPA, OSHA, infection control, and all regulatory requirements.
• Complete all required organizational education and mandatory trainings.

Physical Demands/Working Environment:

• Work is performed in a professional medical office setting, business casual dress environment.
• Extended periods of sitting and/or standing, telephone, and computer work.
• Ability to see information in print and/or electronically.
• The job requires standing, walking, hearing, reaching, talking, and occasional lifting up to 25 pounds.
• Incumbents will be exposed to viruses, disease, and infection from patients and specimens in the working environment.
• Incumbents will be required to work at any facility and be responsible for their own transportation.
• Incumbents may experience traumatic situations, including psychiatric, dismembered, and deceased patients.
• Reasonable accommodations may be made for qualified individuals with disabilities.

Qualifications/Requirements/Skills:

• Knowledge of behavioral health service delivery and referral processes.
• Patient treatment plan development and implementation
• The ability to interview and assess patients, using appropriate assessment tools, and observe, record, and report on an individual's functioning;
• Read and understand assessments, evaluations, observation, and use in developing treatment plans
• Interact positively with patients and their families
• The ability to work independently, as well as collaborate with multi-disciplinary teams and health care providers
• Excellent interpersonal communication skills
• The ability to engage with varying patient populations
• Must be flexible and adaptable to change
• Strong analytical, organizational, and time management skills, able to work with little supervision while handling numerous projects at once.
• Effectively use electronic health records (EHR) to document patient interactions, progress, and other relevant information.
• Proficiency with Microsoft Office applications and reporting tools.
• Ability to maintain confidentiality and exercise sound judgment.
• Consumers' rights
• Local community resources
• Patient record documentation

Education/Training/Experience:

• Bachelor's degree in Human Services Field is required.
• Two (2) years of experience of healthcare coordination, referral management, scheduling, case management, or behavioral health administrative experience preferred.
• Experience working within an integrated behavioral health or Federally Qualified Health Center setting preferred.
• Experience with electronic health records required; Athena experience preferred.