What are the responsibilities and job description for the Referral- Authorization Coordinator position at Nature Coast Primary Care LLC?
Description
Excellent opportunity for growth within the medical field! Become a part of this patient oriented fast paced medical practice. Where we provide medical care for members of our community. We pride ourselves on providing our patients with an overall outstanding experience .
The referral coordinator will be responsible for processing patient referrals to specialists for services not provided by Nature Coast Health Care and serving as the primary contact for internal and external requests for information or assistance related to authorizations.
Requirements
• The Referral Coordinator is responsible for all incoming authorizations, whether received
on paper, by phone or electronic submission.
• Coordinates authorizations for referrals for Nature Coast Health Care patients to outside specialists.
• Prepares referral forms and transmits required information to specialists
• Submits referral information to insurance companies for approval/authorization.
• Communicates with providers as needed to obtain additional or missing clinical
documentation necessary for medical review.
• Manages appeals and coordinates with providers on next steps.
• Coordinates with providers and specialist to schedule urgent referrals for patients.
• Makes calls to patients or external agencies as needed and coordinates with professional
staff for follow up and tracking of referral completion.
• Performs eligibility checks on members as necessary by telephone or electronically as
appropriate.
• Provides great customer service for patients requesting information related to pending authorizations, authorization process or other related issues.
· Maintain knowledge of and work iand maintain compliance with all HIPAA guidelines.
· Perform related duties as assigned by the supervisor.
· Maintain compliance with all company policies and procedures. `
• Excellent customer service
• Technology savvy
• Can establish and maintain effective working relationships with patients, employees and specialists offices.
. Can de-escalate difficult interactions.
• Seeks appropriate help from supervisor or clinical staff to solve problems when
appropriate.
• Can multi-task and maintain professional demeanor in a busy practice environment
• Serves as a liaison between patients, physicians, and other support staff.
· High School Graduate or GED equivalent.
· Ability to perform well in a high-volume environment.
This is a drug free workplace. Background checks are performed.