The Referral Supervisor is responsible for overseeing and coordinating the day to day operations of the Referral Department. This includes monitoring compliance with policies and procedures to assure the goals and objectives for the appropriate and timely processing of referrals are met. Oversees and coordinates the daily activities of the department with regards to quality, timeliness, accuracy and consistency.
Creates and maintains staff schedules, coverage plans and assignments; and manages Paid Time Off.
Monitors staff time and attendance processes daily and makes appropriate corrections, as needed.
Coordinates, schedules and trains staff on referral submission and follow up procedures.
Works closely with Referral Manager to ensure departmental goals are being achieved; advises manager of issues that impede goals from being met.
Ensures complete tracking and follow-up on all referral requests and specialty report requests.
Monitors workflow and ensures that referral processing and follow-up are completed within the guidelines established by the department.
Assists in tracking and reporting on staff productivity.
Monitors quality by performing audits and ensures all associated processes are followed consistently.
Makes recommendations regarding changes, improvements or enhancements to the referrals process and assist with implementation; and assists with developing departmental protocols.
Serves as point of contact and performs trouble-shooting when problem situations arise in the referrals process.
Ensures proper referral documentation is created and maintained according to company protocols.
Provides coverage for processing referrals.
Reviews referrals for completeness and follows up for additional information, if necessary.
Ensures proper use of Current Procedural Terminology (CPT) and current International Classification of Diseases (ICD) codes to meet the requirements of third party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorization. Follows-up with clinician as needed.
Utilizes Electronic Health Record (EHR) functions and/or other software systems to document all pertinent referral or Patient Health Information (PHI).
Maintains confidentiality of PHI by following all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations.
Conducts and/or attends meetings, task forces and committees as appropriate.
Recommends or makes decisions to hire, transfer, suspend, layoff, recall, promote, discharge, assign, reward or discipline. Timely evaluate staff performance against job description criteria and competency assessment and provide guidance and coaching to develop an individual as well as a unit to highest potential.
Assess training needs and promote developmental activities through in house or external training. Keep department staff informed of organizational activities and promote communication, assess and resolve needs and foster teamwork.
Associate’s degree in a healthcare related field, or equivalent experience. High School Diploma or GED equivalent required.
Two (2) years of referral coordination experience in a healthcare setting.
Two (2) years of supervisory or lead experience in a healthcare setting.
Knowledge of medical terminology and procedures, insurance plans, patient referral procedures, and CPT and ICD codes.
Knowledge of the HIPAA Privacy and Security Rule.
Availability to work outside of normal shifts (i.e., 8am to 5pm and on Saturdays).
Computer literacy working with PC-based software applications (e.g., EHR software) and proficiency with the Microsoft Office suite, including Outlook, Word and Excel.
Prefers Completion of a Supervisory Certification Program.
Bilingual in English and Spanish is a plus, but is not required
Ideally seeking Medical Assistant certification.
May be required to travel between all sites and locations therefore California Driver’s License, proof of insurance and clean driving record required.
Ability to work collaboratively with patients, medical staff, co-workers and the public. Ability to work independently and as part of a team.
Ability to understand and adhere to established policies, procedures, protocols, and the ability to make timely and sound decisions. Ability to work with a high attention to detail.
Ability to work effectively under pressure and accurately complete tasks within established times. Ability to find solutions when barriers are identified.
Exceptional phone and customer service skills. Excellent verbal and written communication, interpersonal, organizational, problem-solving, time management, and multi-tasking skills.
On Call Staffing Solutions, Inc. is an Equal Opportunity Employer – Minority/Female/Disability/Veterans