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About the Role

Incumbent is responsible for ensuring that all Purchased Referred Care referrals and payment authorizations are processed according to Seneca Nation Health System (SNHS) policies and procedures. Interprets the appropriate information needed to identify each patient’s individual needs. Provides professional nursing care under supervision, for assigned patients, according to established standards and practices.

Responsibilities

• Collects referral appointment information for medical care as recommended by staff providers with outside medical providers.
• Completes referral documentation to include verifying patient eligibility, address, third party coverage and cost of services.
• Informs and educates patients on referral procedure and obtains appropriate signatures on forms as needed.
• Maintains referral logs and referral tracker system.
• Maintains updated log of approved vendors and their addresses, phone and fax numbers.
• Obtains authorization from insurance carriers through their online portal, phone, or fax.
• Engages and collaborates with outside agencies in an effective and professional manner.
• Assists with the coordination of health records required to be sent to the specialists prior to appointments.
• Orders medical supplies and durable medical equipment that is not available on site.
• Informs patients of any special instructions for testing prior to appointments.
• Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards.
• Cooperates with other personnel to achieve department objectives and maintain good employee relations, interdepartmental objectives, and infection control policies.
• Demonstrates sensitivity to patient's comfort and privacy and expresses willingness to aid patients appropriately.
• Documents all patient contacts according to the provisions of the Privacy Act of 1974.
• Ensures accuracy in recording of patient health records.
• Participates in medical chart audits as directed by supervisor.
• Acts as liaison between patients and medical staff while completing the referral.
• Documents all no-show appointments for outside referrals in designated area in patient’s chart and also notifies referring provider.
• Must be able to demonstrate the knowledge and skills necessary to provide care appropriate to patients of all ages.
• Ensures confidentiality of records according to the provisions of the Privacy Act of 1974 and HIPAA.
• Participates and cooperates in the re-credentialing process with the Contracting and Credentialing Coordinator.
• Must maintain all licensures and certifications of the position.
• Upholds and promotes the value and integrity of the Seneca Nation Health System’s mission statement.
• Will promote SNHS in a positive manner.
• Provides care through a trauma-informed lens by incorporating key principles of both physical and psychological environment safety, trustworthiness and transparency, collaboration of decision-making during treatment plan developments, empowerment of patients by recognizing and building upon individual strengths, as well as recognizing and respecting the diversity of cultural backgrounds and sensitivity.
• Attends all mandatory staff meetings, trainings and in-services.
• Follows all department, SNHS, and Seneca Nation policies.

Requirements

• Current Licensed Practical Nurse NYS licensure required.
• Minimum of 2 years clinical experience required.
• Current CPR/BLS required.
• All required licenses, certifications, and credentials must be obtained prior to hire and maintained throughout employment at the employee’s expense, unless otherwise specified.

Skills

• Excellent communication, interpersonal and patient service skills.
• Good analytical and problem-solving skills.
• Excellent computer skills.

Experience Level

• Minimum of 2 years clinical experience

Benefits

• Monday - Friday (No nights, no weekends and no holidays)
• Health, dental, and vision full coverage for individual
• Short term/long term disability options
• Vacation (annual) + PTO (accrued weekly)
• 16 paid holidays in the calendar year
• 401K - 5% matching
• Parental, medical, education, bereavement leaves and so much more!

About the Company

• Seneca Nation Health System (SNHS)