Job Summary

Duties & Responsibilities

Referral Processing

• Guides patients through McKinley Health Center’s referral process by providing students with written instructions, assisting with completion of required documents, and tracking final reports/patient disposition following completion of the patient’s care/service outside of the Health Center.
• Assists patients in determining insurance coverage and preferred healthcare facility, as needed. Obtains pre-authorization for referrals as required by insurance carriers.
• Assists patients in scheduling referrals appointments and communicates with insurance companies and health care facilities, as necessary.
• Confirms patient acceptance of financial responsibility for services rendered outside of McKinley Health Center.
• Identifies and records ICD10 codes, if required by facility/consultant.
• Reviews special instructions for specialty testing/services with patients as required by consulting facility. Assists patient in completion of any required forms.
• Follows McKinley Health Center guidelines to facilitate timely and accurate medical information exchange.
• Prints all pertinent medical documents from EHR pertaining to the referral and faxes of all ordered medical records to consulting body.
• Completes all necessary EHR documentation.
• Reviews incomplete or pending referrals weekly for further follow up.
• Maintains the Referral Manager module in the electronic health record.

Processes release of confidential medical and mental health information requests.

• Reviews release of information requests for completeness, accuracy and legalities related to state and federal laws.
• Reviews medical and mental health records to determine specific information which may be released based on release requests.
• Redacts medical records as required by law prior to release to ensure patient confidentiality and privacy are protected.
• Releases medical records in a timely fashion for continuity of care, referral, legal issues, etc., and bills for services, when applicable.
• Communicates with patients, providers, 3rd party requestors, Legal Counsel, and McKinley Health Center Staff regarding release of information processes, rules and regulations.
• Serves as resource and educates other clinic staff, including physicians, mental health staff and nurses, in appropriate completion of release of information documents and release process.
• Performs quality assessment activities and gather data for statistical studies, as requested.
• Responsible and accountable to support and ensure a culture of safety, quality and risk management including compliance with ethics.
• Assumes appropriate additional related duties to further the mission of the unit.

Minimum Qualifications

• High school diploma or equivalent.
• Any one or combination totaling two (2) years (24 months) from the categories below:
  • College coursework in any curriculum, as measured by the following conversion table or its proportional equivalent:
    • 30 semester hours equals one (1) year (12 months)
    • Associate’s Degree (60 semester hours) equals eighteen months (18 months)
    • 90 semester hours equals two (2) years (24 months)
    • Bachelor’s Degree (120 semester hours) equals three (3) years (36 months)
  • Work experience performing office/clerical activities, including the use of computer systems.
• One (1) year (12 months) of work experience comparable to the second level of this series.

Knowledge, Skills and Abilities

• Knowledge of the following: State of Illinois Medical Record Laws, State of Illinois Mental Health Code and other state and federal laws pertinent to release of medical information, including HIV and sexually transmitted disease act, HIPAA and FERPA.
• Knowledge of McKinley’s procedures and policies and University Rules and Regulations.
• Effectively communicates with and treats all staff, visitors, patients, providers, administrators, customers and the general public with tact, dignity and respect.