Referral Coordinator

JOB SUMMARY:

The Referrals Coordinator is responsible for handling, monitoring and processing ordered referrals and transitions in an accurate and timely manner with follow-up as required. The position coordinates with all stakeholders in the referral process to ensure that patients receive timely and appropriate care and aim for higher patient satisfaction levels. The Referrals Coordinator also manages requests for patient information and records in compliance with statutory and regulatory requirements.
JOB DUTIES:

• Processing of medical referrals in a timely, coordinated manner and maintaining ongoing tracking and documentation
• Contacting review organizations and insurance companies to ensure prior approval requirements are met. Completion of service request (direct and prior authorization referrals) forms manually and/or through the EMR
• Ensuring complete and accurate registration, including patient demographic and current insurance information
• Communication of service requests to the relevant department for approvals
• Processing and communicating service requests to the specialty offices for processing and scheduling of patient appointments
• Notifying patients of scheduled appointments by phone, in person with appointment information or by mail and document in the patient’s chart
• Following up with specialist offices on pending/outstanding patient appointments, consult reports and documents in the patient’s chart
• Obtaining consult reports; completing and closing referrals in the patient's charts
• Re porting of referral problems to providers, supervisor and administrator for assistance, and resolution
• Processing Medical Records Requests in compliance with policies and regulations
• Contributing to quality care, customer satisfaction, compliance and membership growth at designated practice site
• Acting as point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns
• Establishing and maintaining relationships with identified service providers.
• Other duties as assigned
• Must be willing to work occasional overtime
• Must be willing to work occasional weekends
• Must be willing to help occasionally in other locations

JOB REQUIREMENTS

Education and/or Experience

• Minimum High School Diploma or GED equivalent
• A degree in nursing or related field will be preferred
• A Medical Assistant certification will be highly preferred, but is not mandatory
• CPR certification
• At least 1 year of experience in a clinical or managed care setting
• Prior referrals experience preferred

Required Knowledge, Skills and Abilities

• Knowledgeable about the health care practices, terminology and different clinical specialties
• Knowledgeable about record keeping, billing and reimbursement processes
• Strong customer focus and customer service skills
• Good interpersonal and problem-solving skills
• Must have the ability to satisfactorily speak, read, write and understand English for effective communication
• Knowledge of Electronic Medical Record (EMR) and Practice Management (PM) systems are a plus
• Ability to establish and maintain positive and effective work relationships with healthcare services providers, coworkers and patients
• Ability to work effectively as part of the team
• Strong organizing, coordinating and multi-tasking abilities
• Strong follow-up skills

WORK ENVIRONMENT
All work is performed within a standard health care/primary care clinical setting.

Job Type: Full-time

Pay: $13.50 - $14.50 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• referral: 1 year (Preferred)
• office: 1 year (Preferred)
• Medical terminology: 1 year (Preferred)

Work Location: One location