The HIMS/Referral Coordinator (Referral and Scheduling Coordinator) schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office. The HIMS/Referral Coordinator (Referral and Scheduling Coordinator) performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Work Schedule: Full Time / 40 Hours / M-F / 8a-5p
Job Type: Medical Records, Referrals, and Scheduling Coordination.
Specialty: Primary Care for Seniors
Position Type: Clinic / On-site
Clinic Location: Savannah, GA
On-site Working Expectations:
This is not a remote or work-from-home position. This position requires you to work on-site at our Savannah, GA clinic location.The HIMS/Referral Coordinator (Referral and Scheduling Coordinator) ensures all forms are properly identified, completed, and signed. Enters all necessary information into the system. Communicates with physicians and staff to clarify diagnoses or get additional information. May also assign a code to each diagnosis and procedure. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
This role combines responsibilities in health information management, ensuring the accuracy and confidentiality of patient data, coordination of patient referrals to specialists and healthcare services, along with patient scheduling coordination.
Health Information Management:
Maintain and update patient medical records in accordance with privacy regulations (HIPAA) and practice policies.Ensures accurate and timely entry of patient information into the electronic health record (EHR) system.Monitors patient charts for completeness, accuracy, and compliance with legal, regulatory, and accreditation standards.Input and update patient demographics, medical histories, and other relevant data into the electronic health record (EHR) system.Assists with document management including scanning, indexing, and archiving physical and electronic medical records.Performs regular audits of patient records to ensure data integrity and address any discrepancies.Ensures appropriate coding of medical records, working with clinical staff to ensure proper diagnosis and procedure codes are entered.Support quality improvement initiatives and participate in any audits or reviews related to health information management or referral process.Referral Coordination:
Assists with coordination of patient referrals to specialists, diagnostic services, and/or other healthcare providers.Communicates referral details to patients, including appointment times, specialist information, and any required pre-appointment instructions.Tracks and manages referral statuses to ensure timely follow-up and appointment scheduling for patients. Maintains a referral tracking system to ensure follow-up and continuity of care.Verifies insurance coverage to obtain necessary authorizations or pre-certifications for referrals.Works with insurance companies and specialist to resolve issues related to referrals, including authorization denials or delays.Scheduling Coordination:
Assists with scheduling of patient appointments efficiently, ensuring proper allocation of time and resources for each visit.Assists with managing the appointment calendar for multiple providers, ensuring minimal scheduling conflicts.Confirms patient appointments and sends appointment reminders as appropriate.Assists patients in rescheduling appointments as needed, ensuring minimal wait times as appropriate.Assists patients with understanding their insurance coverage, co-pays, and benefits related to referrals and appointments.Collaborates with clinical staff to ensure timely patient flow.Provides general administrative support to the front office team as needed, including assisting the front desk with patient check-ins during high-volume periods.Use your skills to make an impact
Required Qualifications
High School Diploma or GED.Minimum of 2 years' experience in healthcare administration, health information management, and referral coordination, preferably in a primary care setting.Minimum of 2 years' experience with computer systems or demonstrated technical aptitude and ability to quickly learn new systems. Experience with electronic health records (EHR) systems and medical coding procedures.Familiarity with medical terminology and ICD-10 codes.Experience with scheduling software.Strong knowledge of HIPAA regulations and healthcare privacy standards.Professional appearance and attitude.High level of accuracy in data entry and record management.Proficiency in Microsoft Office Programs (Word, Excel, Outlook) and medical office software.Excellent organizational and time management abilities, with strong attention to detail.Strong written and verbal communication skills with the ability to interact with patients, physicians, clinic staff, and insurance companies.Must be passionate about contributing to an organization focused on continuously improving consumer experiences.Ability to sit for extended periods with use of a computer and other office equipment.Preferred Qualifications
Associate's or Bachelor's Degree in a related field.Possesses any of the following certifications: Registered Health Information Technician (RHIT) certification, Certified Electronic Health Records Specialist (CEHRS), Certified Medical Staff Coordinator (CMSC), Certified Provider Credentialing Specialist (CPCS), Certified Patient Care Coordinator (CPCC), Certified Healthcare Access Associate (CHAA), or Medical Office Administrative Assistant Certification (CMAA).Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience.Experience in Primary Care, Internal Medicine, Family Medicine, Urgent Care, and/or Occupational Health is highly preferred.Bilingual.Additional Information
Alert:
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Interview Format: HireVue:
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Benefits:
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
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Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.