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.
The DetailsFirst point of escalation for all case related issues requiring guidanceResponsible for daily completion of assigned patient referrals, while meeting production requirementsReviews, processes and supports Specialist referral requests by Concentra sites as defined by the marketObtains authorization for Specialist referrals and schedules appointments accordinglyEnsures that appropriate networks and Concentra Advanced Specialists are used when applicableProvides all necessary information such as medical records, prescriptions, etc. to payorCommunicates with stakeholders, payor, employer, and patient as appropriateRecords all appropriate information via OA/CR module of OccuSource per Concentra policyBuilds relationships with provider, employer and payor communitiesIdentifies trends or patterns in missed capture and opportunities to gain capture; communicates these ideas and trends to Lead and SupervisorHandles calls according to the call guidelines of the departmentParticipates in quality assurance processes including but not limited to the audit program, case reviews and training sessionsThis 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/CredentialsHigh school diploma or GED equivalentAssociated Degree from an accredited college preferredJob-Related ExperienceCustomarily at least one year of demonstrated experience in medical environment - service delivery (referrals, claims, insurance, billing, etc.)Experience with Worker's Compensation preferredProficiency with scheduling/insurance verification softwareJob-Related Skills/CompetenciesConcentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and FlexibilityThe ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policiesFamiliarity with Microsoft Excel, Outlook, WordExcellent communication skills and ability to communicate (both written and orally) effectively with colleagues at all levels of the organizationMust display proper business etiquette and be skilled in the arts of diplomacy and tactExcellent time management skills including the ability to multitask and prioritize in a fast-paced environmentAbility to build and maintain productive business relationshipsExemplary ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutionsOutstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalismExcellent writing and documentation skillsStrong attention to detailAbility to work independentlyAbility to handle special projectsAbility to handle multiple tasks, projects, duties, and priorities, when assigned Additional Data Employee Benefits401(k) Retirement Plan with Employer MatchMedical, Vision, Prescription, Telehealth, & Dental PlansLife & Disability InsurancePaid Time Off & Extended Illness Days OfferedColleague Referral Bonus ProgramTuition ReimbursementCommuter BenefitsDependent Care Spending AccountEmployee Discounts
This job requires access to confidential and critical information, requiring ongoing discretion and secure information management.
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Concentra is an equal opportunity employer, including disability/veterans
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