Referral Coordinator

About the role

As a Referral Coordinator, you will assist patients by coordinating and obtaining required medical referrals and managing pre-collection activities for scheduled procedures. This role is crucial to supporting efficient patient care and revenue cycle operations by preventing referral-related delays, communicating financial responsibility to patients prior to procedures, maintaining accurate records, and ensuring appropriate documentation is completed.

Responsibilities

• Preemptively reviews upcoming patient appointments to identify referral requirements and ensure all required referrals are on file prior to services being rendered.
• Identifies missing, expired, or incomplete referrals and proactively contacts primary care provider offices to obtain the appropriate referral.
• Communicates with patients when their involvement is necessary to obtain a required referral from their primary care provider or insurance plan.
• Communicates necessary information to patients, staff, and therapists; verifies and records information in the patient's medical record.
• Answers telephone, screens calls, clears voicemail, and returns patient calls in a timely manner.
• Answers questions regarding patient's upcoming appointments, referral status, and pre-collection requirements.
• Updates patient information in the patient electronic medical record and registers patients as applicable.
• Confirms patient demographics and paperwork for accuracy, completion, and missing information.
• Ensures the proper clinical chart documentation and required referral orders are present for all new patient appointments.
• Relays prior authorization and/or referral needs to the authorization team and desk staff in accordance with patient insurance coverage prior to services being rendered.
• Maintains responsibility for following up on outstanding referral requirements and communicates unresolved issues to the appropriate team members to prevent delays or cancellations.
• Notifies all applicable staff as to the status/completion of above processes.
• Courteously interacts with patients, family members, visitors, and members of the healthcare team; directs patient questions and/or complaints to the appropriate department; keeps patients informed of authorization/referral status.
• Performs pre-collection activities for scheduled procedures in accordance with organizational policies and established workflows.
• Reviews available patient financial responsibility information, including applicable copays, deductibles, and coinsurance amounts.
• Contacts patients prior to scheduled procedures to communicate estimated financial responsibility and to collect applicable payments.
• Documents all pre-collection outreach, patient communication, payment attempts, and outcomes.
• Schedules patients for follow-up office visits or procedures.
• Assists in uploading medical records to the patient electronic record.
• Assists with proper routing of incoming faxes and documents.
• Maintains medical records in accordance with practice policies and procedures.
• All other duties as assigned.

Requirements

• High school Diploma or GED.
• Accurate typing skills, minimum 50 words a minute.
• Knowledge of medical terminology.
• Customer service skills.
• Excellent verbal and written communication skills.
• Working knowledge of computer programs.
• 1 year experience of referrals and insurance verification.
• Strong organizational skills with the ability to manage follow-up on outstanding referrals and pre-collections.

Preferred Qualifications

• 2-3 years of medical front office experience.
• Previous experience with medical referrals, insurance verifications, patient collections, or healthcare revenue cycle.
• Experience working within a specialty medical practice or pain management setting.