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REFERRAL COORDINATOR
Job Title: REFERRAL COORDINATOR
Job Code: 4616
FLSA: E
Job Level: B2
Revised Date: 10/01/2020
Supervisory Responsibility:
General Description of the Job Class
The Duke Primary Care (DPC) Referral Coordinator provides a comprehensive scheduling experience to meet the various needs of patients and referring providers within a Duke Primary Care clinic or centralized engagement center. The DPC Referral Coordinator performs various appointment and access-related duties for Duke Primary Care clinic(s) to include scheduling appointments from a referral, following up on referrals faxed externally, and closing the loop on all reconcilable referrals placed. The DPC Referral Coordinator remains current on providers, service locations, and insurance payers, while providing the highest levels of service excellence to each patient.
Duties and Responsibilities of this Level
Elements that contribute to the unique characteristics of the position include:
- Referral Coordinator I - autonomous problem-solving and decision- making as it relates to referrals, patient appointment and scheduling support, and other duties as assigned by clinic leadership.
- Referral Coordinator II - autonomous problem-solving and decision- making as it relates to referrals and authorizations, patient appointment and scheduling support for multiple DPC clinics daily, trainer for new referral coordinators, and network level process- improvement referral projects and initiatives.
Referral Duties:
Provide accurate information to patients regarding various services, providers, and locations available within the Duke University Health System and the surrounding community.
Actively identify, listen, and understand the needs of each patient. Ask thoughtful questions to determine the appropriate resources or actions to be taken.
Professionally communicate both verbally and in writing with patients, providers, internal specialty departments, and clinics in the surrounding community.
Provide referral and radiology support within designated pod as assigned for PTO coverage.
Monitor voicemail of assigned clinic(s).
Assist in scheduling for more than 30 specialty departments.
Provide referral and radiology coverage to other DPC clinics as needed.
Utilize 31 different decision trees to schedule patients within the Duke University Health System.
Utilize referral standard work documents and resources and performs work within established standards at all times.
Make judgements guided by standard work on how to prioritize patients and complete tasks.
- Additional Responsibilities for Referral Coordinator II - Obtain authorizations and assist in covering 7 authorization work queues. Handle 2-4 clinic assignments daily including referral and radiology work queues and authorizations for each assigned clinic.
Patient Scheduling:
Identify patients using 2 identifiers in accordance with compliance guidelines.
Schedule appointment from the referral using scheduling guidelines and questionnaires in order to determine the appropriate provider, location, and visit type.
Maintain knowledge and resources to schedule patients outside of Duke as appropriate.
Ability to answer questions from patients and ordering providers on where to send referrals for quickest access, closest geographic location, as well as specific insurance requirements.
Provide patient with appropriate directions and pre-visit appointment information.
Identify and document special needs; schedule interpreters as needed.
Review assigned work queues and prioritize by emergency, urgent, and routine referrals ensuring all referrals are worked within 48 hours.
Use all available resources to contact the patient, including phone numbers and MyChart, while following compliance guidelines.
Improvement Initiatives:
Maintain liaison with other offices and departments to coordinate referrals, foster collaboration, leverage resources, and help to accomplish program objectives.
Contribute to program effectiveness by communicating trends and recommending modifications to current workflows.
Proactively communicate issues to Referral Manager as it relates to access and decision trees.
Actively participate in DPC continuous improvement processes and practice level improvement projects.
Additional Responsibilities for Referral Coordinator II - Complete time studies to conduct preliminary analysis of trends as assigned by Referral Manager. Actively participate and engage in network level process improvement projects.
General:
Exceed patient experience expectations.
Meet or exceed daily productivity goals as set forth by department.
Demonstrate Duke's values and behaviors in every interaction.
Consistently use "Words that Work" and "RELATE" in all daily interactions.
Comply with all regulatory and compliance policies and procedures.
Strong ability to handle complex workflows utilizing critical thinking skills.
Perform registration, front desk coverage, scanning, and other related duties incidental to the work described herein as assigned by clinic leadership.
- Additional Responsibilities for Referral Coordinator II - Serve as trainer for all new DPC referral coordinators to include training on referral standard work and referral authorization process.
Required Qualifications at this Level
Education
A high school diploma or equivalency, is required.
College or completion of post-secondary education is strongly preferred.
Experience
Minimum of 1 year of health care related experience. An associate degree or higher may substitute for the experience requirement.
Accurate typing and data entry skills; excellent customer service and communication skills and knowledge of HIPAA requirements regarding patient confidentiality.
- Strongly Preferred for Referral Coordinator II - Two years of health care related experience; Active user of electronic medical records (EMR) software; Experience with obtaining insurance authorizations; Comprehensive knowledge of primary care referral protocol; Familiar with process-improvement methods (PDSA, A3, 5S); Comfortable training peers
Degrees, Licensure, and/or Certification
Knowledge, Skills, and Abilities
Distinguishing Characteristics of this Level
The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
