About this role
Overview
Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.
Do you want to use your problem solving skills and knowledge of customer service to help improve the health of America's workforce? At Concentra, we serve more than 500 medical centers and 130 onsite clinics nationwide. Concentra colleagues remain fueled by our driving purpose: to provide outstanding patient experience by delivering the highest quality healthcare in an efficient, affordable, and caring manner. We do this by putting all customers first.
Responsibilities
Position Summary
The Referral Management Coordinator maintains high standards for quality and an exceptional patient experience in accordance with Concentra’s policies, procedures and applicable regulations. The Referral Management Coordinator processes referrals requests and authorizations while working closely with physicians, employers and payors. Customer services is a top priority in order to achieve a positive impact on the cost and quality of care rendered to injured employees.
Physical Requirements:
- Must be a current Texas Resident
- Must remain a Texas Resident during the duration of employement within the Referral Department
- Must be able and willing to travel to a local Concentra to complete new hire orientation
The Details
- 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.
Qualifications
Education/Credentials
- High school diploma or GED equivalent
- Associated Degree from an accredited college preferred
Physical Requirements:
- Must be a current Texas Resident
- Must remain a Texas Resident during the duration of employement within the Referral Department
- Must be able and willing to travel to a local Concentra to complete new hire orientation
Job-Related Experience
- Customarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)
- Experience with Worker's Compensation preferred
- Proficiency with scheduling/insurance verification software
Job-Related Skills/Competencies
- 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
Other facts
About Concentra Career Choice
WHO WE ARE:
Concentra is the leader in occupational health with 40+ years of improving the health of America's workforce, one patient at a time. More than 11,000 Concentra colleagues provide occupational medicine, onsite health care, physical therapy, and telemedicine services from nearly 520 medical centers and 130+ onsite clinics nationwide.
THE CONCENTRA WAY:
Living out our Mission, Vision, and Values to improve the patient experience, redefine health care, and help people achieve lifelong well-being.
OUR MISSION:
Improving the health of America’s workforce, one patient at a time.
OUR VISION:
Every person is treated the Concentra Way: quality clinical care and a positive customer experience from welcoming, respectful, and skillful colleagues.
OUR VALUES:
A healing focus, a selfless heart, and a tireless resolve.
Our goal at Concentra is living out our Mission, Vision, and Values to improve the patient experience, redefine health care, and help people achieve lifelong well-being,
SCAM ALERT: Concentra has been informed that scammers are using our name to scam individuals who believe they are applying for an opportunity with Concentra or receiving a job offer from Concentra. These scammers can be very convincing, going so far as to steal the profile pictures from our actual recruiters from their LinkedIn profiles and using email addresses that contain the word ‘Concentra’ such as ‘@ConcentraCareers’ or ‘@ConcentraJobs’ or '@concentracareerdesk.' The scammers will typically ask you to send money at some point (for equipment, training, or a uniform, etc.). A LEGITIMATE CONCENTRA RECRUITER OR HIRING MANAGER WILL NEVER ASK YOU TO SEND US MONEY. Also, you will never receive a job offer from us if we have not verbally interviewed you. For more information on recruiting scams or to report a recruiting scam visit the website of the Federal Trade Commission at https://www.consumer.ftc.gov/articles/0243-job-scams.
What you'll do
- The Referral Management Coordinator processes referral requests and authorizations while ensuring high standards for quality and patient experience. They communicate with stakeholders and handle case-related issues, maintaining relationships with providers, employers, and payors.
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