POSITION SUMMARY
The Referral and Medical Records Specialist manages all external referrals for additional care needs for their assigned team. This includes working directly with patients, external referral sources, insurance companies, and all members of the team to facilitate, coordinate, and follow-up on external referrals
KC CARE CULTURE CODE
KC CARE follows a culture code in all we do. Our code determines how we work, treat each other, and move health equity forward. As an employee of KC CARE, you will:
· Put patients first, always
· Treat all people with dignity, respect, and kindness
· Create safe places for others to share their voice; encourage creativity
· Always strive for improvement; keep learning
· Own your work, action, and mistakes – no one is perfect
· Have fun – work should be fun and we want you to have fun at KC CARE![]()
ESSENTIAL DUTIES AND RESPONSIBILITIES
· Manages all external referrals for assigned care team, which includes contacting patients, following up with hospitals and specialty providers, and updating electronic health records with referral status notes, follow-up medical records, and other pertinent care information.
· Responsible for the management and flow of external referrals for additional care needs for their assigned team.
· Assists with referral prior authorizations by completing paperwork and working with insurance companies and other payors.
· Scans follow-up referral notes and medical records into the electronic health records for assigned team
· Ensures strict confidentiality, adhering to established HIPAA guidelines and regulations and health center policies and procedures.
· Serves as an administrative support for team-based care model.
MINIMUM REQUIREMENTS![]()
- High school degree or equivalent
- Three years’ experience as a medical assistant, referral clerk or prior authorization specialist
- HIPAA knowledge
- Medical terminology knowledge
PREFERRED REQUIREMENTS
· Associate degree from an accredited college or university.
- Ability to read, write, and communicate in English and Spanish
WORKING CONDITIONS AND DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Conditions
General working conditions are in a healthcare facility. As such, there is a potential exposure to virus, disease, and infection from patients while performing the duties of this job. May experience traumatic situations including psychiatric traumatized and deceased patients. Travel may be expected to community meetings, client homes, or other agencies.
Physical Demands
While performing duties of this job, employees are regularly required to sit, walk, and stand; talk and hear; both in person and by telephone; use hands repetitively to finger, handle, feel, or operate standard office or clinical equipment; reach with hands and arms; and occasionally lift up to 20 pounds.
Mental Demands
While performing the duties of this job, employees are regularly required to use written and oral communication skills; read, analyze, and interpret data, information and documents; analyze and solve non-routine and complex problems; use math and mathematical reasoning; observe and interpret situations; learn and apply new information or skills; perform highly detailed work on multiple, concurrent tasks; work under intensive deadlines with frequent interruptions; and interact with others outside of their department.
Duties and responsibilities, as required by business necessity may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing. Scheduling, shift assignments, and location may be changed at any time, as required by business necessity.