Referral Management Clerk

Job Overview:

The Puget Sound Military Appointing Center (PSMAC) is a centralized services center that serves as the primary point of contact for PSMHS beneficiaries for PAS, RMS, and CLRS as they seek healthcare services, and is therefore a critically important resource in our healthcare delivery system.

*Call center that manages inbound and outbound calls from beneficiaries, validates beneficiary eligibility, schedules, cancels, and reschedules patient appointments in order to provide timely access to quality healthcare.
*Provide outbound calls in order to schedule specialty appointments for beneficiaries who have received a direct care specialty referral.
*RMS processing supports the timely scheduling of specialty care referrals ordered by MTF HCPs.
*RMS services span a range of functions to include, but not limited to: identifications of specialty referrals to be deferred to the network, ensuring processing in accordance with DHA timeliness, and tracking status of network referrals.
*Review of each MTF generated referral and determining a disposition as either "Appoint to MTF" or "Defer to Network (DTN)" based on specific MTF specialty clinic capabilities, capacities, and DHA access to care standards.
*Maximizing the retention of specialty care within the MHS to support the readiness of the *Medical Force, within capability and capacity parameters.
*Additional contracted services include processing Secure Message Service (SMS) transmittal requests for appointments, drive-time mapping capabilities in support of specialty care appointing, as well as outbound letters to beneficiaries referred for MTF specialty care.

Duties of the Referral Management Clerk

*Disposition all routine referrals as either Appoint to MTF, Defer to Network, or route to MTF Referral Management Center (RMC) IAW standardized PSMHS business policy.
*Document and report complaints received, errors found, and the specific corrective action taken by the contractor. Errors shall include those identified by patients/beneficiaries, clinic and/or MTF staff, and direct to the contractor.
*Process incoming referrals (ROFR) from the MCSC network providers and MTFs according to eMSM, DHA requirements and standardized guidelines.
*Record and track status and disposition on all Prime/Select/VA/ ROFRs, MTF, and network referrals and communications received, per DHA and PSMHS business rules.
*Review all referrals and appoint to MTF referrals, or return to requester based on policies and procedures.
*Provide Monthly ReportingEdit Job RequirementsQualificationsHigh school diploma or General Educational Development (GED) equivalency
*Skilled in Word, Excel, Access, and other software programs
*Excellent communication, interpersonal and customer service skills
*Able to define problems and obtain solutions
*Must be able to obtain clearance to access the work site located on a CSMHS military *installation and be granted a Common Access Card (CAC).
*Must be able to clearly communicate, verbally and written with coworkers and clinic staff.

Healthcare administrative experience - preferredEdit QualificationsBenefits* Competitive Salary
* Accrued paid time off
* Paid Federal Holidays
* Health and Wellness benefit to help cover medical costs
* Benefits concierge to answer any benefit related questions
* Dental and Vision Plans
* 401k Plan
* Designated Program Manager throughout the lifecycle of your employment

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday
• No weekends

Ability to Relocate:

• Fife, WA 98424: Relocate before starting work (Required)

Work Location: In person