Referrals Supervisor
Trinity Health Of New England

Job Info

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Employment Type:
Full time
Shift:

Description:
Oversees the day-to-day functions of the Referrals team within the Referrals and Authorization Center. Responsible for training, guidance, and mentorship on prior auth process for specialty consultative and procedural based referrals while providing leadership to staff within the department. Works closely with the Regional Trinity Health Medical Group Service Line Directors and the Referrals Trainer by providing feedback on any trends, concerns or workflows that may impact network integrity, access, care coordination and hospital capture.
Trinity Health Of New England Medical Group is looking for a Medical Assistant to join a mission-driven healthcare team. Our vision is to provide state-of-the-art healthcare to those within our local communities, creating a positive impact for each individual that walks through our doors.

The Referrals Supervisor oversees the day-to-day functions of the Referrals team within the Referrals and Authorization Center. Responsible for training, guidance, and mentorship on prior auth process for specialty consultative and procedural based referrals while providing leadership to staff within the department. Works closely with the Regional Trinity Health Medical Group Service Line Directors and the Referrals Trainer by providing feedback on any trends, concerns or workflows that may impact network integrity, access, care coordination and hospital capture.

Top Reasons to Work at Trinity Health of New England:

• Great benefits effective day 1!
• Competitive pay
• Mission-Driven Team Environment

You Will Be Responsible For:

• Supervising: Works closely with direct leadership to ensure workflow, productivity and department standards are met; provides training and development of new staff and/or workflows; acts as liaison between external offices, providers, and staff; responsible for communicating problems, suggestions, or concerns to management; suggests improvements to workflows and ensures that staff in the department are meeting department standards. Understands and adheres to all HIPAA privacy and security regulations, policies, and practices. Supervises and coordinates the day-to-day activities of the referrals department team. Acts as a role model and provides leadership to staff in the department on a daily basis.
• Recognizes, addresses, and recommends solutions due to issues with Epic EMR build and ensure resolutions are followed through with IT team to ensure referrals are accurately processed in accordance with regional practice standards.
• Responsible for referral denial charge review workqueue which entails thorough research within patient's chart/encounter to ensure re-processing of payer claims are submitted in a timely manner.
• Works closely with the Referrals Trainer, Service Line Directors, and clinical department staff as well as the business services staff in the performance of various duties including development of booking guidelines and protocol.
• Processes all referrals received via the web, telephone, or appropriate payer specific paperwork. Manages and maintains the Epic referrals workqueues, prescreening for completeness of information, urgency, and other designated criteria.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

BA or BS required. Experience within a medical office or billing department preferred. Minimum of three (3) years' experience in referral workflows, scheduling and processing within Epic required. Medical terminology preferred. Knowledge of patient billing preferred.

Experience with leadership directional approach or previous supervisory experience with demonstrated skill in developing and coaching staff required.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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