Community Health Centers of the Rutland Region
Referral Supervisor
Community Health Centers of the Rutland Region, Rutland, Vermont, United States, 05701
Job Description
Job Description COMMUNITY HEALTH: Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties.
ABOUT THE ROLE: The referral supervisor obtains reviews and inputs insurance authorization and referrals for patient services. The referral supervisor also ensures payment for services by verifying benefits with insurance providers.
FUNCTIONS OF THE POSITION: Supervises daily activities of referral staff, providing guidance, training, and performance feedback to ensure accurate and timely processing of authorizations and referrals. Coordinates work assignments, monitors workloads, and adjusts staffing as needed to maintain efficient workflow and service delivery. Participates in the hiring, onboarding, and ongoing training of referral team members. Conducts regular audits of referral and authorization processes, ensuring compliance with organizational standards and regulatory requirements. Serves as the first point of contact for referral team questions and escalated issues, facilitating problem-solving and ensuring prompt resolution. Develops and maintains standard operating procedures for the referral team, updating documentation as necessary to reflect best practices. Assists the Patient Access Manager in developing performance metrics, monitoring outcomes, and recommending process improvements. Reviews providers order to ensure referrals are in place prior to service. Receives, maintains and notes in the system all referrals for services. Run reports on a scheduled basis to obtain accuracy and to keep providers and staff informed of referrals/testing. Interviews and assists patients with authorization documents as needed. Maintains appropriate reports according to Community Health policy, state and federal requirements. Monitors and tracks patient authorizations, informing supervisor of any expired dates if applicable. Participates in required meetings.
OTHER DUTIES: Research error/concerns and coordinate with community resources for improved referral workflows. Track daily progress to stay up to date on referrals/orders/x-rays. Point person for Patient Access manager and hospital specialist offices. Track x-rays/orders to be sure they are completed. Track close the loop process and flew huddles. Weekly email to relay new info slash process to department. Other duties as assigned.
SKILLS REQUIRED FOR SUCCESS: High school diploma or equivalent; Associates Degree preferred Three years of experience preferred as a referral supervisor or similar experience in a healthcare role. Knowledge of medical billing/coding, skills in using electronic medical record system, proficient computer skills, and strong customer service skills. Skill identifying problems and recommending solutions Ability to communicate clearly.
HOW WE SUPPORT YOU: Work Life Balance Generous Time Off Medical, dental, and vision insurance. Health savings account option. Robust 403 (b) retirement savings plan, with employer match and 100% vesting schedule. Comprehensive Wellness Program.
Job Description COMMUNITY HEALTH: Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties.
ABOUT THE ROLE: The referral supervisor obtains reviews and inputs insurance authorization and referrals for patient services. The referral supervisor also ensures payment for services by verifying benefits with insurance providers.
FUNCTIONS OF THE POSITION: Supervises daily activities of referral staff, providing guidance, training, and performance feedback to ensure accurate and timely processing of authorizations and referrals. Coordinates work assignments, monitors workloads, and adjusts staffing as needed to maintain efficient workflow and service delivery. Participates in the hiring, onboarding, and ongoing training of referral team members. Conducts regular audits of referral and authorization processes, ensuring compliance with organizational standards and regulatory requirements. Serves as the first point of contact for referral team questions and escalated issues, facilitating problem-solving and ensuring prompt resolution. Develops and maintains standard operating procedures for the referral team, updating documentation as necessary to reflect best practices. Assists the Patient Access Manager in developing performance metrics, monitoring outcomes, and recommending process improvements. Reviews providers order to ensure referrals are in place prior to service. Receives, maintains and notes in the system all referrals for services. Run reports on a scheduled basis to obtain accuracy and to keep providers and staff informed of referrals/testing. Interviews and assists patients with authorization documents as needed. Maintains appropriate reports according to Community Health policy, state and federal requirements. Monitors and tracks patient authorizations, informing supervisor of any expired dates if applicable. Participates in required meetings.
OTHER DUTIES: Research error/concerns and coordinate with community resources for improved referral workflows. Track daily progress to stay up to date on referrals/orders/x-rays. Point person for Patient Access manager and hospital specialist offices. Track x-rays/orders to be sure they are completed. Track close the loop process and flew huddles. Weekly email to relay new info slash process to department. Other duties as assigned.
SKILLS REQUIRED FOR SUCCESS: High school diploma or equivalent; Associates Degree preferred Three years of experience preferred as a referral supervisor or similar experience in a healthcare role. Knowledge of medical billing/coding, skills in using electronic medical record system, proficient computer skills, and strong customer service skills. Skill identifying problems and recommending solutions Ability to communicate clearly.
HOW WE SUPPORT YOU: Work Life Balance Generous Time Off Medical, dental, and vision insurance. Health savings account option. Robust 403 (b) retirement savings plan, with employer match and 100% vesting schedule. Comprehensive Wellness Program.