Referral Coordinator - Dorchester or Quincy, MA (On-site) at Gather Health

Boston, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

17 Aug, 26

Salary

0.0

Posted On

19 May, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Referral Coordination, Insurance Verification, Electronic Health Records, Medical Terminology, Patient Scheduling, Authorization Processing, Interpersonal Communication, Multi-tasking, Athena EHR, CPT Coding, ICD Coding, HCPCS Coding, Microsoft Excel, Outlook Calendar, Slack, Microsoft Teams

Industry

Health;Wellness & Fitness

Description

Description Who we are: Gather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology, Gather Health’s solution drives substantial care outcomes by addressing the whole person needs of our target demographic: older, dual eligible adults, the fastest growing government segment. To address the needs of these clinically and socially complex patients, Gather Health’s Social Primary Care solution is comprehensive and wholistic in nature, encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients. Gather’s model achieves superior care by individualizing care and is reinforced by a three-prong approach: a unique care model quarterbacked by PCPs and supported by multi-disciplinary care teams, tailored Social Care Plans that are led by Gather Guides and facilitated by deeply rooted community partners, and a proprietary “Tech Enabled Home Model.” Founded in 2022 and born out of the Healthcare Foundry Portfolio, Gather Health is addressing a $1 trillion market in primary care for older adults. Today, Gather Health operates in Massachusetts and is working with a multitude of payer partners on aligning value-based care economics to deliver integrated care. Gather’s leadership team has a track record of building and scaling innovative primary care platforms focused on vulnerable populations, including VillageMD and Commonwealth Care Alliance. Gather has raised $30M backed by Maverick Ventures, Khosla, and HC9 Ventures. Summary of Referral Coordination Partner Role: The Referral Coordination Partner will play a vital role in connecting our patients with specialists and other providers outside of Gather Health and ensuring a seamless process. There are many aspects that require coordination that can be confusing to the patients – things such as scheduling a date and time, running insurance verifications, obtaining/sending electronic medical records from/to other clinics/hospitals, etc. – and the Referral Coordination Partner will be the central organizer in all activities related to referrals for our patients. Day-to-day Duties: This clinic-based role will include, but not limited to, the following responsibilities: Schedules and pre-registers patients for exams and procedures with specialists and providers outside of Gather Health and confirms those scheduled appointments with specialists and providers Notifies patients of appointment information, including, date, time, location, etc. Communicates with patients with regards to their transportation needs; contacts insurance carriers to verify transportation benefit eligibility, and coordinate accordingly Ensures patients’ external missed appointments are rescheduled and communicated to the clinical care team Uses Web resource portals such as Availity and OneSource to generate authorizations Work through the denials/appeals process with Gather Health providers Coordinates authorizations and acquisition of Durable Medical Equipment Participates in daily and weekly clinical care team meetings Communicates with the clinical care team to ensure patients referral needs are met Addresses referral-based phone calls and messages in a timely fashion Retrieves consultation notes, test results, and medical records - submits appropriate clinical documents to specialist offices and uploads documents into electronic medical record platform (Athena) Provides backup support for front desk duties as necessary Performs other related duties as assigned Requirements Requirements: Minimum of one year experience coordinating referrals in a medical clinic High school diploma or G.E.D. Minimum of one year experience working with an Electronic Health Record software Solid understanding of medical terminology Strong interpersonal skills with experience working in settings requiring frequent communication via phone and in-person Experience with basic office tools such as email, Outlook calendar, Excel, Slack/Teams, etc. Strong verbal, written, and reading comprehension skills in English Proven track record of detail orientation and the ability to multi-task in a busy clinic Ability to work from 8am to 5pm Monday through Friday Ability to work from home for part of the time, with appropriate setup conducive to performing work including phone calls Ability to work for any employer in the United States Preferred Skills: Experience with CPT and/or ICD coding, or HCPCS Experience with seniors, under-served populations, individuals with disabilities or other complex social needs Experience working in a primary care clinic setting Experience working with Athena We are committed to supporting every aspect of your life by offering a total rewards package designed to support your health, financial security, and work-life balance: Health: Comprehensive medical, dental, and vision with day-one eligibility Protection: Company-paid Life, Short-Term, and Long-Term Disability insurance Retirement: 401(k) with company match and immediate vesting Time Off: Generous PTO that increases with tenure and 11 paid company holidays Wellness: Employee Assistance Program (EAP) and supplemental benefit options Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law.

Responsibilities

The Referral Coordination Partner manages the end-to-end process of connecting patients with external specialists, including scheduling, insurance verification, and medical record transfers. They act as the central organizer to ensure seamless care transitions and coordinate authorizations for procedures and medical equipment.