Referral Management Clerk
Referral Management Clerk
SUMMARY. This position provides clerical/administrative support in the Referral Management Center for customer service, referral tracking, referral appointing, and reporting activities. This position will support the daily functions of specialty care referral appointing, referral review and coordination, beneficiary counseling and referral tracking at the MTF.
1.1 Mandatory knowledge and skills.
1.1.1 A fully qualified typist with a minimum of 50 WPM is required.
1.1.2 General medical ethics, telephone etiquette, and excellent communication and customer service skills.
1.1.3 General office administrative and clerical skills to perform receptionist duties and answer telephones.
1.1.4 Ability to communicate effectively, both orally and in writing.
1.2 Education. High school diploma or General Educational Development (GED) equivalency.
1.3 Experience. Preferred two (2) years of healthcare administrative experience in either an inpatient or outpatient care setting within the last three (3) years.
1.4 Work Environment/Physical Requirements. The work is primarily sedentary. However, there may be some physical demands. Requirements include prolonged walking, standing, sitting or bending.
1.5 Remote Eligibility: This position is not remote eligible. Eligibility is determined by Management or Human Resources
2. UNIQUE MILITARY HEALTH CARE SYSTEMS/PROCEDURES:
2.1 The Composite Health Care System (CHCS) and the newest version, Armed Forces Health Longitudinal Technology Application (AHLTA), or other MTF ICD-B programs must be utilized for referral management services. Access will be granted by local MTF connectivity and the contractor shall comply with MHS communications and Government IT security standards and policies. The military facility will provide system accounts for Referral Case Management (RMC) personnel after required training and security procedures have been completed by the contractor. If the Military Health Service processes moves away from specified systems, the government will modify the task order accordingly.
3. PERFORMANCE OUTCOMES:
3.1 Greets patients/visitors at a front desk, referral center or office setting.
3.2 Answers main office phone line(s). Directs telephone calls to appropriate section for assistance, handles independently or takes messages as required.
3.3 Reviews referrals for administrative completeness and researches covered benefits prior to processing.
3.4 Determines patient eligibility for services and arranges and schedules medical appointments for referred care.
3.5 Provides general instructions to patients and ensures patients have necessary documentation for referred health care services.
3.6 Obtains updates and files medical records as needed.
3.6.1 Organizes and researches patient records, extract needed information, and review records for referral results within established guidelines.
3.6.2 Request medical records and ensures arrival of medical records prior to appointment(s).
3.6.3 Initiates and locates patient medical records as needed.
3.6.4 Obtains documentation as requested by healthcare providers (test results, or documentation not yet filed in records).
3.7 Ensures referral results are returned to the referring provide and to the medical record within required timelines. Assists with follow up, written or verbal, as necessary.
3.8 Utilizes the referral tracking data collection tool. Calculates metrics, and compiles monthly reports, as directed by the MTF.
July 13, 2021