Referral Coordinator

Essential Duties And Responsibilities

• Prioritizes and tracks referrals by their urgency and addresses them in a timely manner.
• Participates in the selection, orientation and training of referral personnel.
• Ensures complete demographic, insurance information and appropriate/pertaining clinical information is sent to referred specialists.
• Contacts insurance companies to ensure prior approval requirements are met.
• Presents necessary medical information such as, history, diagnosis and prognosis to insurance companies if deemed necessary to prove medical necessity of services.
• Reviews details and expectations about the referral with both ordering providers and patients.
• Requests new referrals to be ordered when applicable.
• Develops and implements systems as required by EMR functionality and/or regulatory agencies.
• Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.
• Point of contact for patients and specialists for any questions or rising concerns.
• Affords assistance in problem solving potential issues related to their referral due to language or social barriers.
• If unable to help, assists in finding the right point of contact to further help.

Qualifications

• Experience with referrals in healthcare preferred.
• Experience with Electronic Health Records required.
• Proficient knowledge of insurance policies.
• CPT and ICD-10 knowledge.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.
• Strong customer service skills, professional attitude, clerical expertise, IT competence, and strong organizational skills.
• WC / OCCMED experience.
• Urgent Care experience.