Referral Coordinator

Duties And Responsibilities

• Manage and coordinate all referrals generated in the Medical department from start to finish.
• This will include sending referrals to specialists, ensuring their receipt, informing patients of referrals, and following up to see such appointments were kept.
• Responsible for verifying eligibility and benefits through insurance companies, including prior authorization request.
• Responsible for coordinating and processing prior authorizations for each assigned referral.
• Proactively work with Medical Assistants to ensure follow up on patients’ specialty appointments.
• Schedule specialty appointments for patients; notify and remind patients of such appointments by phone and by letters through the United States Postal Service.
• Provide patient education on specialty appointments and address all patient questions in a manner that ensures their understanding.
• Refer patients to NAHC’s Eligibility Specialist as needed to help ensure coverage of care as related to specialists and the insurance they accept.
• Maintain a tracking system for referred appointments that includes referred date, dates and times of referral appointments, missed appointments, and the recall procedure.
• Check Referral voicemail once per clinic (at minimum), return calls, and provide referral statuses to patients.
• Document patient telephone calls in an EHR Telephone Template.
• Document all telephone calls and letters in the EHR.
• Develop and cultivate positive working relationships with specialist providers.
• Document referral workflows and support Site Director in developing and editing on-boarding materials for incoming staff as related to referral flow and management, as necessary.
• Train incoming staff on referral processes, as needed. This may include one-time trainings, or on-going trainings and on-boarding.
• Proactively work with RN Clinic Manager, Lead Physician and Site Director to resolve any technical or flow issues regarding referrals.

General Duties

• Attend internal and external meetings as requested by supervisor.
• Member Care: Demonstrate understanding and apply working knowledge of safety policies and ensuring safe member practices.
• Employee Safety: Safely perform all duties; follow required protective protocols to ensure personal safety as well the safety of others.
• Maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.
• Quality Improvement: Actively participate in internal quality improvement teams and work with members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards, when assigned.
• HIPAA: Keep all protected health information (PHI) confidential and abide by HIPAA policies for the release and disclosure of any PHI. Report unauthorized use of disclosure of PHI immediately, to supervisor or HIPAA security officer.
• Work well under pressure, meet multiple and often competing deadlines.
• At all times demonstrate cooperative behavior with supervisors, subordinates, colleagues, clients and the community.