Referral Clerk

<p>Referral Clerk</p>

<p><br></p>

<p>Evergreen Family Medicine is committed to providing excellent care for your family with clinics in Roseburg, Sutherlin and Myrtle Creek Oregon.&nbsp; Evergreen Family Medicine serves outpatient needs, including Urgent Care, Family Practice, Women’s Health, Occupational Health, and school-based telehealth.</p>

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<p>Evergreen Family Medicine is a Drug Free Workplace. All candidates that are offered employment will be required to pass a pre-employment drug screen and background check.</p>

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<p>Responsibilities and Duties:</p>

<ul>

<li>Maintains confidentiality according to HIPPA regulations and EFM policies. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>

<li>Adheres strictly to EFM departmental standards and policies, including state and federal regulations.</li>

<li>Communicates effectively and professionally with coworkers, managers and patients via phone, email or in person.</li>

<li>Receives and coordinates all referrals and prior authorization requests, submitting appropriate information in a timely manner.</li>

<li>Maintain current knowledge of all insurances including verifying benefits and eligibility for OHP, DCIPA &amp; Atrio including PCP assignment. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>

<li>Advocates for patients by creating appropriate patient cases, requests, communications and appointments in Athena, on paper and in person.</li>

<li>Maintains current working knowledge of medications, procedure and diagnosis codes with the ability to ascertain medical necessity requirements. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>

<li>Communication with outside provider offices, facilities and insurances via phone, fax and computer.</li>

<li>Keeps an active working knowledge of Athena, engages in continuing education and trainings as offered by manager or company.</li>

<li>Self Manages to stay on task, maximizes efficiencies and does not distract others as well as encourages others to do the same.</li>

<li>Maintains a positive attitude, does not take work issues personally and does not allow personal issues to affect the work day.</li>

<li>Ensures on a daily basis to promote an environment filled with teamwork, a positive outlook and constant professionalism. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>

</ul>

<ul>

<li>All other duties as assigned by manager.&nbsp;</li>

</ul>

<p><br><br></p>

<p>Qualifications and Skills:</p>

<ul>

<li>High school diploma or equivalent required; additional medical office or healthcare administration training preferred.</li>

</ul>

<ul>

<li>Minimum 1–2 years of experience in a medical office, referral coordination, prior authorizations, or related healthcare setting.</li>

</ul>

<ul>

<li>Working knowledge of medical terminology, medications, and common procedure/diagnosis codes (ICD-10, CPT).</li>

</ul>

<ul>

<li>Familiarity with insurance plans including OHP, DCIPA, Atrio, Medicare, Medicaid, and commercial carriers.</li>

</ul>

<ul>

<li>Experience verifying insurance benefits, eligibility, and PCP assignment.</li>

</ul>

<ul>

<li>Proficiency with electronic health record systems; Athena experience highly preferred.</li>

</ul>

<ul>

<li>Understanding of HIPAA regulations and ability to maintain strict patient confidentiality.</li>

</ul>

<ul>

<li>Ability to meet productivity standards and manage multiple tasks in a fast-paced environment.</li>

</ul>

<ul>

<li>Strong organizational skills with attention to detail and accuracy.</li>

</ul>

<ul>

<li>Communication Skills:&nbsp;Communicates clearly, professionally, and respectfully through phone, email, and in-person interactions with patients, coworkers, managers, and external providers.</li>

</ul>

<ul>

<li>Referral &amp; Authorization Coordination:&nbsp;Ability to create, track, and manage referrals and prior authorizations with accuracy and timely submission of required documentation.</li>

</ul>

<ul>

<li>Technical Proficiency:&nbsp;Comfortable navigating EHR systems, faxing platforms, insurance portals, and general computer applications.</li>

</ul>

<ul>

<li>Problem-Solving:&nbsp;Uses sound judgment to assess medical necessity and determine appropriate next steps for patient care coordination.</li>

</ul>

<ul>

<li>Teamwork:&nbsp;Promotes a positive, collaborative work environment and supports coworkers with professionalism and encouragement.</li>

</ul>

<ul>

<li>Time Management:&nbsp;Works independently, stays on task, and maximizes efficiency without disrupting others.</li>

</ul>

<ul>

<li>Professionalism &amp; Attitude:&nbsp;Maintains a positive outlook, handles stressful situations appropriately, and does not allow personal issues to impact work performance.</li>

</ul>

<ul>

<li>Adaptability:&nbsp;Willingness to engage in ongoing training, education, and process improvements.</li>

</ul>

<ul>

<li>Customer Service:&nbsp;Advocates for patients by ensuring accurate documentation, communication, and follow-through in all cases.</li>

</ul>

<p><br><br></p>

<p>Physical requirements:</p>

<ul>

<li><br>Prolonged periods sitting at a desk and working on a computer.</li>

<li><br>The employee is frequently required to walk; use hands and fingers, handle, or feel; and reach forward with hands and arms. </li>

<li><br>The employee is occasionally required to sit and stoop, kneel, or crouch.&nbsp;</li>

<li>Must be able to lift up to 35 pounds at times.</li>

</ul>

<p>&nbsp;</p>

<p>Our culture and values are every employee’s responsibility: The needs of our patient come first S.P.I.R.I.T</p>

<ul>

<li>Stewardship</li>

<li>Patient &amp; Population Focused Health Care</li>

<li>Integrity</li>

<li>Respect</li>

<li>Innovation</li>

<li>Teamwork</li>

</ul>