The Referrals & Medical Records Supervisor is primarily responsible for the oversight of administrative duties and support within the medical department primarily related to referrals, authorizations, medical records and front desk staff (receptionist).
- Oversees support staff and ensures coordinated service delivery through monitoring of productivity.
- Hires, train, manages discipline and evaluates administrative staff.
- Coordinates with other departments (i.e. case management) and agencies as necessary to facilitate the delivery of medical services as needed.
- Maintains relationship with specialty practices, pharmacies, community groups (i.e. Walgreens, Mental Health)
- Routes clients/patients to the appropriate areas within the agency.
- Generates reports to program director in a timely manner. Ensures timely retrieval by support staff of incoming calls and voice messages as well as return calls as per agency’s policy. Responsible for ensuring patient compliants are kept to a minimum resulting in less than 10% complaint rate.
- Supervises the correct verification of patient insurance carrier/coverage to ensure proper processing of referrals by staff and according to procedure.
- Ensures timely response to all correspondences and tasks (via letter, email, faxes).
- Ensures proper maintenance of patient’s health records in agency’s database (i.e. EHR, Provide) and other datasystems and/or patient’s charts as required.
- Supervises and supports staff as needed in the processing of referrals for patient specialists visits including in house specialists and outside providers (via insurance portals, phone calls, etc.)
- Ensures updates are made in EHR regarding appointments made for specialists, patients attendance and/or comments, etc.
- Ensures staff processes additional information requested by insurance companies for authorizations (medical records, documentation from providers, etc).
- Ensures staff properly handles authorizations denials and appeals on behalf of the patient and documents outcomes in EHR.
- Finds alternatives, as deemed neccesary by providers, for denied authorizations.
- Ensures external 3rd party documentation (i.e. labs, consultations reports etc) is collected and entered in the patient’s electronic health records (EHR).
- Ensures proper and timely closing of tasks as it relates to referrals and open orders via EHR.
- Ensures medical records are scanned into patients health records and tasks to the assigned provider (i.e. Social Security Administration, legal offices, outside providers or patient request)
- Prepares invoices for payments of medical records requests.
- Prepares medical records as requested by printing from EHR, and prepping for faxing or mailing.
- Ensures documentation for new patients is collected and recorded in patient’s electronic health records (EHR).
- Ensures patient documentation is fully completed and recorded in agency’s database (i.e. Intergy).
- Ensures proper tasking to provider when records are received and closing of tasks from providers when record is obtained.
- Ensures medical office (front desk and waiting area) is kept clean and tidy at all times.
- Ensures online trainings are current as required (My LearningPointe and other trainings).
- Ensures medical operations fully comply with agency and HIPAA, Joint Commission and Patient Centered Medical Home requirements.
- Understands and appropriately acts upon assigned role in Emergency Code System.
- Understands and performs assigned role in agency’s Continuity of Operations Plan (COOP).
- Participates in agency developmental activites as required.
- Other duties as assigned.
High school diploma required. Associate degree in in medical field or related education is highly recommended. At least two years of supervisory experience in medical settings specifically referrals/authorization and medical records processing. Specific training in medical back office procedures (Referrals/Authorizations and medical records) is highly recommended. Bilingual (English-Spanish) is preferred. Computer knowledge should include Microsoft Outlook, Word and Excel and electronic health records systems (EHR). Excellent problem solving, communication, organizational and teamwork skills are required. Ability to work with multicultural and diverse population is required.
SALARY: $35,000 – $50,000 Annually
LOCATION: 3510 Biscayne Boulevard, Miami, FL 33137
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