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Concentra · 2 weeks ago

Referral Management Coordinator - Worker's Compensation

Plano, TX

Full-time

Onsite

Entry Level

1+ years exp

Concentra is a leading healthcare provider serving over 500 medical centers and 130 onsite clinics nationwide. The Referral Management Coordinator is responsible for maintaining high standards for quality and exceptional patient experience by processing referral requests and authorizations while collaborating with physicians, employers, and payors.

Health CareHospitalMedicalPrimary and Urgent CareTherapeuticsWellness

Responsibilities

First point of escalation for all case related issues requiring guidance

Responsible for daily completion of assigned patient referrals, while meeting production requirements

Reviews, processes and supports Specialist referral requests by Concentra sites as defined by the market

Obtains authorization for Specialist referrals and schedules appointments accordingly

Ensures that appropriate networks and Concentra Advanced Specialists are used when applicable

Provides all necessary information such as medical records, prescriptions, etc. to payor

Communicates with stakeholders, payor, employer, and patient as appropriate

Records all appropriate information via OA/CR module of OccuSource per Concentra policy

Builds relationships with provider, employer and payor communities

Identifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and Supervisor

Handles calls according to the call guidelines of the department

Participates in quality assurance processes including but not limited to the audit program, case reviews and training sessions

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice

Qualification

Worker's Compensation experienceScheduling software proficiencyMedical environment experienceMicrosoft ExcelCommunication skillsCustomer service skillsMultitaskAttention to detailTime management skillsWork independently

Required

High school diploma or GED equivalent

Must be a current Texas Resident

Must remain a Texas Resident during the duration of employment within the Referral Department

Must be able and willing to travel to a local Concentra to complete new hire orientation

Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)

Proficiency with scheduling/insurance verification software

Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility

The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies

Familiarity with Microsoft Excel, Outlook, Word

Excellent communication skills and ability to communicate (both written and orally) effectively with colleagues at all levels of the organization

Must display proper business etiquette and be skilled in the arts of diplomacy and tact

Excellent time management skills including the ability to multitask and prioritize in a fast-paced environment

Ability to build and maintain productive business relationships

Exemplary ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions

Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism

Excellent writing and documentation skills

Strong attention to detail

Ability to work independently

Ability to handle special projects

Ability to handle multiple tasks, projects, duties, and priorities, when assigned