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Time Type:
Full time
Department:
Referrals
All Locations:
Revere
Description:
The Appointment & Referral Coordinator is expected to make all patients feel welcome, over the phone or in person, while capturing comprehensive and accurate information. The Coordinator is responsible for scheduling external and internal specialty care appointments and processing authorizations as assigned by the department manager in accordance with department and clinical guidelines and patient’s preference; document referral processing activities per department and EBNHC guidelines. Appointment and Referral Coordinators are expected to provide the department manager with timely feedback about referral trends, barriers to scheduling specialty appointments and engage in process improvement projects as needed.
Appointment and Referral Coordinator are expected to:
Maximize reimbursement to the health center from various managed care payors by scheduling specialty appointments appropriately, and communicating the outcome to the patients and/or the specialist’s office;
Establish and maintain professional collaborative relationships with internal and external customers
Educate/communicate with patients about their insurance so that they schedule specialty appointments within their insurance network and/or understand the financial consequences of seeing providers out of network;
Provide patients with the highest quality of customer service in accordance with EBNHC’s mission and vision;
Review and address Epic in-basket messages in a timely manner, taking action within 24-48 hours of receipt.
Essential Duties & Responsibilities
With great attention to detail, schedule all external specialty visits for your assigned Referral workqueue per department guidelines; cover other workqueues as needed. Exhaust all avenues to achieve the goal on securing the appointment within the requested timeframe. Follow up with primary care provider if unable to schedule as order specifies to explore alternatives.
Process 65 referrals or more a day for BMC work queues
Process 40 or more referrals a day for non BMC referrals
Review and address Epic in-basket messages in a timely manner, taking action within 24-48 hours of receipt
Actively answer all incoming calls with a goal of assisting the caller while there are on the phone
Use correct codes for sending referrals electronically to BMC
Ability to understand and interpret medical terminology in the orders for the purpose of making a relationship between the diagnosis and what accompanying documentation is required, such as recent lab results or other diagnostic test results.
Direct schedule for BMC where applicable
Work cooperatively and respectfully with other departments and staff at all levels of the organization.
Demonstrates self-direction, self-motivation, and independence. Exercises excellent judgment, in knowing when and how to involve your supervisor; utilize all available resources before seeking assistance.
Take initiative to perform a wide variety of activities contributing to the smooth functioning of the department.
Displays outstanding customer service skills when interacting with patients and other customers.
Ensures patient/family confidentiality.
EDUCATION:
High School diploma and related college degree and/or equivalent work experience.EXPERIENCE:
Experience in a health care setting – at least one year
Ability to understand and interpret various managed care insurance benefits and guidelines.
Knowledge of, and experience with medical terminology extremely helpful
Working knowledge of the health center’s computer systems for registration, billing, appointment scheduling, and managed care options, and the various managed care plan electronic/on-line authorization technology (NHP NET, NEHENLite, WebMD, Tufts, etc.)
SKILLS/ABILITIES:
Excellent customer service and interpersonal skills.
Fluency in English & Spanish is strongly needed for most positions
The ability to work independently in a fast paced environment.
Ability to communicate with internal and external customers.
Some medical terminology
Exceptional organizational skills
There’s a reason East Boston Neighborhood Health Center is ranked as one of the “Top Places to Work” by The Boston Globe. It is because we are committed to maintaining a truly supportive and welcoming environment — for both our employees and our patients — that reflects our mission and culture. A huge focus of which is to offer important benefits so you can be your best inside and outside of work.
Striving to be an employer of choice, we offer progressive benefits, a variety of schedules, and the satisfaction of working with a diverse workforce whose unity of purpose is a real force for achievement. Plus, our Education & Training Institute is an attractive resource for many of our employees who seek to broaden their skill base and advance their careers.
Medical & Dental Coverage
Life and Disability Insurance
Privileges at Boston Medical Center for Providers
401(K) Retirement Plan
Educational Assistance
Flexible Spending & Transportation Accounts
Paid Holidays, Vacations, Sick and Personal Time
A Generous Staff Development Benefit
Excellent Malpractice Coverage
A Designated Medical Staff Office for Physician Support
Free Parking
And Much More…