Referral Coordinator

Duties and Responsibilities

• Referral Management:
  • Process and expedite patient referrals to specialty offices and external providers.
  • Maintain ongoing tracking and documentation of referrals, ensuring patients receive appointments in a timely manner and are cleared for their visits prior to their arrival.
• Insurance Coordination:
  • Verify insurance benefits and eligibility, obtaining necessary pre-authorizations for services.
  • Act as a liaison between patients, providers, and insurance companies, proactively addressing any prior authorization or benefit-related issues.
• Patient Communication:
  • Review details of the referral with patients, ensuring they understand the process, appointment details, and any required preparations.
  • Contact patients regarding any pending referrals or diagnostic testing, providing clear instructions and follow-up information.
• Collaboration and Coordination:
  • Work closely with healthcare providers, clinical staff, and external specialists to gather necessary clinical information and facilitate patient care.
  • Cook up appointments for hospital follow-ups, special medical procedures, and specialist visits.
  • Aid in scheduling preliminary testing when required and ensure completion before specialist visits.
• Documentation and Record-Keeping:
  • Accurately document all referral information in the electronic medical record (EMR) system, ensuring up-to-date status tracking.
  • Maintain communication logs and relevant referral documentation, adhering to clinic policies and compliance standards.
  • Run periodic reports for nursing and provider staff to monitor patient compliance and for quality improvement initiatives.
• Problem Solving and Emergency Referrals:
  • Handle urgent and emergency referrals by prioritizing cases and coordinating with emergency services or on-call specialists.
  • Expedite insurance verification and documentation in emergency situations to avoid delays in care.
  • Follow up after emergency care to ensure appropriate follow-up appointments are scheduled.
• Compliance and Best Practices:
  • Ensure all activities adhere to healthcare regulations, privacy laws, and institutional policies.
  • Participate in quality improvement initiatives and share best practices with colleagues to enhance overall process efficiency.
  • Provide training and support to staff as needed on referral processes and policies.

Qualifications

• High school diploma or general education diploma (GED) or experience may replace education.
• Two (2) years relevant work experience preferred.

Benefits

• Compensation with comprehensive benefits including Profit Sharing Plan, Medical, 401(k), and Long-Term Disability.
• Transportation Plan, Generous Paid Vacations and Holidays.

Pay

Hourly rate: $20

Schedule

N/A