Medical Assistant - Referral Clerk

Position Summary

The Medical Assistant - Referral Clerk has dual role in supporting back office clinical and administrative operations to ensure smooth and efficient processing of patient healthcare. Administrative duties include verifying eligibility, checking benefits, documenting physician direct referrals and pre-authorizations of certain services (via phone, fax or e-mail), scheduling appointments with specialist and other community resources as instructed by primary care provider. Clinical duties include back office processing and patient care-related services under the direction of the professional staff.

Schedule:

• Flexible, may require some evening and weekends

Duties and Responsibilities

• Process HMO, CPE, CPSP, and other specialty referrals
• Completion of authorization request form
• Fax or email referral request to respective IPA/Health Plan, County and etc. along with the required pertinent information to support the request.
• Notify patients (if necessary) regarding authorization decision; approved or denied
• Schedule appointments with Specialists and notify patients
• Follow up status on referrals for completion
• No show / reschedule
• Follow-up visit(s) either with Specialist or PCP
• Consultation Reports
• Responsible for filing completed referral forms in the patient medical record
• Maintain referral logs per financial class, i.e., HMO, etc.
• Weekly report to QM on specialty utilization
• Comply with the IPA, Health Plan and/or Programs UM Protocols
• Ensures HIPAA Compliance at all times
• Work closely with Clinic Medical Practitioners and maintain communication on referral status
• Review and maintain referral log
• Act as liaison between clinic and managed care department
• Interviews and exits patients, completing appropriate medical agency and consent forms, ensuring patient understanding and obtaining signatures.
• Document patient intake in the Electronic Health Record (EHR), which includes chief complaint, medical history, social history, vitals, and appropriate tests/labs performed and immunizations administered.
• Perform phlebotomy, injections, vitals if deemed by the Medical Practitioner, including but not limited to visual acuity, audiometric screening, venipuncture, injections, and specimen handling
• Perform Point-of-Care testing, such as Blood Glucose, Urinalysis, EKG, HbA1c, INR, Blood Chemistry, Pregnancy Test, Bilirubin, and other standard primary care back office procedures.
• Assist Medical Practitioners (i.e. physicians, PA-C, NP) with patient examinations and procedures as directed
• Coordinate interdisciplinary and integration of primary care medical services with in-house Dentistry, Optometry, Endocrinology, Mental Health services
• Review patient medical record to ensure completeness and accuracy
• Route appropriate medical orders, results, documentation and instructions to the appropriate personnel
• Maintain and stock clinical inventory supply and dispensary
• Maintain equipment for clean and operational use, as well as maintain calibration, sterilization, and repair/maintenance logs
• Clean, stock and maintain exam rooms.
• Follow OSHA and universal precaution protocols
• Strict adherence to the policy and procedure manual
• Provide or direct patients/individuals seeking information regarding programs and services offered by NECC
• Other duties as assigned by Clinic Manager