Referral Coordinator

About the role

Presbyterian is hiring a skilled Referral Coordinator at Presbyterian Rust Medical Center. This is a full-time position with a weekday schedule, Monday through Friday.

Responsibilities

• Navigate complex requests from referring providers and their offices, primarily via phone
• Develop and maintain positive working relationships with providers and referring offices
• Address requests and concerns using knowledge of organization and ability to identify resources; use high level of diplomatic skill to handle all calls in positive and professional manner
• Advanced scheduling for specialty or radiologic procedures; recognize payor requirements and obtaining prior authorization/certification/referrals for visits/procedures
• Return scheduling knowledge to include the ability to scrub schedules for accuracy and efficiency in home department
• Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, etc
• Achieve exceptional experience for providers and referring providers offices by using CARES, AIDET and EPE tools
• Ensure all communications with providers and patients occurs in a timely manner
• Communicate with referring providers and their offices to schedule referrals, answer questions, and arrange provider-to-provider communication as needed
• Address and attempt to appropriately resolve concerns and requests in the moment by using resources and appropriate escalations to find solutions
• Coordinate with departments throughout program to gain access for referrals
• Follow up with referring providers to ensure they know the status of their referral or request
• Maintain strong knowledge of program operations and processes in order to guide referring providers and answer questions about potential referrals and perform appropriate hand-offs
• Coordinate with Business Development partner to collect feedback from referring offices in order to ensure an exceptional experience
• Manage conflict and appropriately request the help of a supervisor when needed
• Foster effective patient relations with patients, the public and providers by listening, responding and escalating when appropriate
• Work with program providers, testing departments, and health plan representatives to facilitate creating access for referrals and members as needed
• Facilitate provider-to-provider communication as requested
• Coordinate incoming referrals from the time they're received to completed
• Enter all faxed referrals into EHR
• Guide and assist referring offices through Prior Authorization request requirements and processes
• Understand surgical and procedural scheduling workflows in order to appropriately prepare and hand-off referrals
• Ensure relevant medical records are requested
• Ensure any testing required for referral is ordered and scheduled
• Communicate effectively to ordering clinician when any restriction, such as access, restricts or prohibits scheduling as ordered
• Support program providers with scheduling, access coordination, and referral communication needs
• Refer as appropriate to on site Financial Advocate, or for uninsured to the Financial Advocacy Center
• Validate prior authorization/certification/referral are secured PRIOR to a scheduled procedure or test, alerting stakeholders (patient, patient representative, OR, etc) if a breakdown occurs
• Answer all incoming provider calls; including from outpatient referring offices, inpatient requests for consults, and internal program providers
• Follow established workflows for paging the appropriate program providers regarding consult requests
• Formulate complete and accurate telephone encounter messages and route to the appropriate Epic in-basket pool to support operational aspects of patient care

Qualifications

• High school or equivalent
• Minimum 18 months experience in a medical office setting with significant MD interaction
• Proficiency in prior authorization/certification/referral process
• Must pass EPIC competency for Registration at completion of Epic Clerical Training class
• Short-term training in Medical Terminology
• Working knowledge of CPT and ICD-10 coding
• Pass annual competency exam for all areas of responsibility
• Requires strong organizational and multi-tasking skill sets
• Significant customer service skill set
• Must be able to function under pressure while maintaining professionalism

Benefits

• Medical, dental, and vision insurance
• Short-term and long-term disability
• Group term life insurance
• Optional voluntary benefits
• Employee Wellness rewards program with gift cards and wellness activities including wellness challenges, webinars, and preventive screening