(Archived) Medical Services Coordinator

CHENEGA HEALTHCARE SERVICES

Ramstein Air Base, Germany

The Medical Services Coordinator shall have a basic knowledge level to include: principles of customer service, TRICARE, quality control and risk management, medical terminology, medical forms and records management, guidelines for release of medical information, medical and legal ethics, applicable systems technology, supply procedures and information systems.

• Review referrals for suitability, administrative, and clinical completeness, covered TRICARE benefit, and required tests and pre-work. Coordinate with referring provider in cases where additional referral information is required.
• Verify patients are registered in Composite Healthcare Computer System (CHCS), Enterprise Wide Referral and Authorization System (EWRAS), and Defense Eligibilty Enrollment Reporting System (DEERS); updates demographic information as needed.
• Assist with Right of First Refusal ( RFR) determinations for specialty care that can be provided within the Medical Treatment Facility (MTF) using Service Availability (capability) Listing (SAL) and information systems that link the referral to the appointment to the Access to Care (ATC) category and standard.
• Schedule specialty referral appointments to MTF, Direct Care System, or Network/non-network providers with ATC standards 90 percent of the time.
• Coordinate with specialty referral clinics (internal or external) on special patient instructions and tests required prior to appointment. Advise patients of the provider, location, time, and day of referral appointments or request the patient call back for appointment information.
• Provide pre-appointment instructions to patients; locate referral requests; print diagnostic reports and treatment profiles; ensure patients leave MTF with all necessary documents appropriate for the referral care episode and the referral provider knows where to return his/her results.
• Contact patients in event referral requests are invalid, disapproved by second level review and reschedule patients as soon as possible or instruct patients of other health care options.
• Receive and appropriately forward clinical phone consult requests from patients and submit referrals when required for medical necessity and appropriateness review.
• Advise all categories of patients of what their referral and health treatment options are as related to their eligibility and beneficiary status.
• Track referrals to include obtaining report from the MTF, Direct Care System, and network/non-network providers with established standards. The primary responsibility to obtain Network/Non-network results and return them to the referring provider resides with the MCSC/MTF.
• Document patient appointments, either in the MTF, another MTF, in the Network or with a non-network provider in the Consult Tracking Tool. Document in Consult Tracking Toll the name of the referring provider/Primanry Care Manager (PCM) and MTF for purposes of return of completed specialty results.
• Ensure that results from other MTF’s and from Network/non-network providers are returned to the referring provider and to the medical record within required timelines and follow up as necessary.
• Document in Consult Tracking Tool that electronic referral results are properly routed in AHLTA to the Primary Care Manager and paper referral results are properly routed to Primary Care Manager and filed in patient’s health record.
• Greet patients, screen, and appropriately route phone calls, serve as the “central clearing house” for providers and patients needing help with referrals.
• Provide requesting provider and Medical Evaluation Board (MEB) with administrative support.
• Provide administrative support to the Service Treatment Record (STR) program.
• Other duties as assigned

• High School degree required; Bachelor’s degree preferred.
• A minimum of one (1) year administrative support in medical field preferred.
• Ability to type a minimum of 40 words per minute.

Knowledge, Skills and Abilities

• Computer skills, Microsoft Office, Excel, Power Point, Publisher, Word Expertise
• Fluent in the English language both oral and written.
• Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce

Physical 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.)

• While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee may use repeated motions that include the arms, wrists, hands and/or fingers. The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.