Trillium Health, a Federally Qualified Health CenterLook-Alike, is a community health center offering access to affordable care forall, with a special focus on meeting the needs of LGBTQ people, communities ofcolor, and underserved populations.
Nationally recognized for outstanding patient-centeredcare, the team at Trillium Health provides a wealth of knowledge andexperience. Our expansive array of services, including testing and treatment,laboratory services, primary and specialty care, and an on-site pharmacy, makesit easier for patients and clients to receive the complete care they need, allin one place.
Our authentic commitment to diversity and inclusion isevidenced through our hiring practices, our employee programs, and ourcompassion for everyone we serve. Based in downtown Rochester, with satellitelocations in Bath and Geneva, and MOCHA centers in Buffalo and Rochester,Trillium is deeply invested in building community. We proudly sponsor manyother nonprofit organizations throughout the area and participate in a widerange of community events.
Trillium’s employee-centered company culture andexceptional benefits have contributed to impressive growth in recent years,raising our staff total to more than 250. We hope you will consider joining uson this upward path and becoming a part of the Trillium Health family.
We arecurrently recruiting for a ReferralSpecialist.
·Assign thepatient to the appropriate specialty provider or facility based on thepatient’s current medical needs as defined by the primary care provider.
·Provide all therequired medical history information regarding the patient to the specialtyprovider or facility.
·Determinationof primary responsibilities for the medical bill and identifying any changesmade by the clients or payers.
·Coordinate withinsurance carriers and specialty practices to obtain prior authorizations, precertifications ad referrals on applicable plans which include HMO, PPO and POShealth plans and documents all benefit information into the patients’electronic medical record.
·Coordinate andcommunicate with Care Managers and other departments to facilitate thefinancial counseling and other insurance issues.
·Ensure thatpatient’s financial counselor is aware of any copayments, deductibles, etc.
·Fax medicaldocumentation as needed and requested by clinical staff and outside agencies.
·Keep both thepatient/client and the corresponding provider informed of scheduled detailssuch as day/time and place of visit.
·Assist inproviding information to the patient/client on any preparation required beforethe visit.
·Inform thespecialty provider or facility of any special needs for the patient such asinterpreters, transportation, escort, etc.
·Enter all thereferral information into the electronic medical record system.
·Contactpatient, specialty provider or facility to reschedule missed appointments forpatients if applicable.
·Schedule anypre and post follow up appointments with the medical or specialty provider ifapplicable.
·Obtain alllabs, radiological, surgical and other medical reports from the specialtyprovider or facility to ensure continuity of care.
·Send allpertinent information to the referred organization.
Referral Tracking and Quality Reporting
·Keep track ofpatient/client referrals in the system and follows up with clients who have missedreferral appointments.
·Maintain anaccurate up-to-date monthly report of scheduled patient offsite appointments.
·Run and monitora weekly crystal report to capture any missed referrals made by the providers.
·Track andmaintain a “No Show” report for offsite appointments and informs the providers,care managers and other staff if applicable.
·Maintain anyquality reports required to meet Patient Centered Medical Homes, Meaningful Useand Health Homes requirements.
·Follow up withfacilities for patient/client information.
·Requires theability and commitment to respect and support inclusiveness and diversityincluding but not limited to individuals of different backgrounds, cultures,races, ages, sexual orientations, gender identities or expressions,experiences, opinions, etc.
·Requiresindividual demonstration of commitment to the One Trillium behaviors andbusiness impacts and modeling them in the organization.
·Responsible formaintaining confidentiality of all patient, client, employee, protected andproprietary information.
·Employees areaccountable for meeting the performance standards of their departments and mustparticipate as requested in compliance audits, process improvement and qualityimprovement plans.
·Other specificduties as assigned.
High School diploma or GED required with a minimum of 2years recent insurance verification, referrals and prior authorizationexperience in a medical office or clinic is required.Associate’s degree preferred in HealthEducation, Health and Human Services.
Excellent verbal and written communication skills, goodtyping and computer skills.Excellentcustomer service skills, team player and positive attitude.Ability to make decisions and solveproblems.The ability to speak, read orwrite a foreign language is desirable.
Trillium Health offers employment to all employees &applicants. No person shall be discriminated against in employment on the basisof race, age, color, marital status, religion, creed, sex, sexual orientation,gender identity or expression, national origin or ancestry, disability, veteranstatus, status as a domestic violence victim, genetic condition orpredisposition, or any other characteristic protected by law.