Referral Management Assistant shall provide administrative support for the Medical Treatment Facility (MTF) staff and beneficiaries. You shall ensure patient flow is optimized by assisting patients at the Referral Management Center (RMC) to process their referrals to specialty care and making their appointments to include computerized appointment booking and appointment validation.
• Provide services with basic knowledge for 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, and information systems. Knowledge of coding desirable, but not required.
• Reviews referrals for suitability, administrative, and clinical completeness, covered TRICARE benefit, required tests and pre-work. Coordinates with referring provider in cases where additional referral information is required.
• Verifies patients are registered in Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), EWRAS, and Defense Enrollment Eligibility Reporting System; updates demographic information as needed.
• Assists with Right of First Refusal (RFR) determinations for specialty care that can be provided within the 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.
• Assists team members in providing pre-appointment instructions to patients as indicated.
• Locates referral requests and ensures appropriate documents are available prior to all specialty appointments.
• Prints diagnostic reports and treatment profiles as necessary.
• Receives and appropriately forwards clinical phone consult requests from patients.
• Submit network/non-network referral results through the Translations Automated Database Input and Verification System (TADIVS) for translations.
• Tracks referrals to include obtaining reports from MTF, Direct Care System, and network and non-network providers within established standards.
• Documents patient appointments, with the MTF, another MTF, in the network, or with a non-network provider.
• Documents the name of the referring provider/PCM and MTF for purposes of return of completed specialty results.
• Follows-up with MTF providers who did not complete referral results within required timelines.
• Ensures that results from other MTFs and from Network/non-network providers are returned to the referring provider and to the medical record within required timelines and follows up as necessary.
• Documents that paper referral results are properly filed in patient’s health record.
• Assists in preparation of monthly reports as indicated.
• Greets patients, screens, and appropriately routes phone calls.
• Relieves requesting provider from as many administrative burdens as possible.
• Serves as the “central clearing house” for providers and patients needing help with referrals.
• You shall not introduce services other than those included herein without prior recommendation to, and approval of, the CO.
• Prepare all documentation to meet or exceed established standards of the MTF to include but not limited to: timeliness, legibility, accuracy, content, format, complete patient identifying information, medically consistent, and error free.
• Responsible for creating, maintaining, and disposing of only those Government required records.
• Patient lists, no matter how developed, shall be treated as privileged information. Lists, and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the Government.
• Shall be able to type with a minimum of 40 words per minute and have the ability to speak and write English and German.
• A certification of language proficiency is required.
Read Speak Write Read Speak Write
3 3 3 3 3 3
• Shall be knowledgeable in general medical ethics, health records administration, telephone etiquette, office management methods, excellent communications and customer service skills, strong organizational background, and computer operations to include Microsoft Windows and Microsoft Office applications.
• Must understand the importance of deadlines. Knowledge of coding is desirable, but not required.
• High School diploma or General Educational Development (GED) equivalency. Completion of Administrative Assistant program is desirable.
• Completed training in Microsoft Windows and Excel is required.
• Completed and maintains Basic Life Support Training.