Referral Coordinator

Principal Responsibilities

• Process incoming and outgoing referrals accurately and efficiently within the standards of care timelines: Urgent – 24 hours, Routine – up to 5 business days.
• Ensure all necessary documentation and medical records accompany each referral, including: Hospital notes, imaging, laboratory results.
• Regularly log into IPA portals (e.g., HCLA, CFC, HDMG, LA Care Direct).
• Log into the referral database and Next-Gen daily.
• Add appropriate service codes and assist patients in finding specialists as recommended by their PCP.
• Act as the primary liaison between patients, referring physicians, and specialists.
• Provide patients with information regarding referral procedures and appointments.
• Contact the respective IPA to ensure patients' needs are met.
• Verify insurance coverage and obtain pre-authorizations for specialist visits.
• Communicate with insurance companies to resolve any issues related to referrals.
• Maintain accurate and organized records of all referrals and communications.
• Track referral outcomes and follow up with patients regarding their care.
• Assist patients with questions or concerns about the referral process or specialist visits.
• Ensure adherence to relevant regulations and organizational policies.
• Participate in quality improvement initiatives related to referral processes.
• Review all referrals weekly and monthly to ensure processing standards are met.
• Schedule appointments and verify that patients receive the care requested by their primary care provider.
• Notify the primary care provider if a patient does not follow through with a referral appointment.
• Maintain an environment conducive to patient comfort and confidentiality.
• Aid other clerical staff in clearing charts and answering phones.
• Provide information and respond to patient inquiries in person, by mail, and by phone.

Requirements

• Medical training or experience preferred (i.e. Medical Assistant Certification)
• Proven experience working in a healthcare setting, preferably in a role involving patient referrals or coordination.
• Proficiency in using electronic medical records (EMR) systems and other relevant software applications.
• Strong organizational skills with the ability to prioritize tasks and manage time effectively.
• Excellent communication and interpersonal skills, with the ability to interact professionally with healthcare providers, patients, and team members.
• Attention to detail and accuracy in data entry and record-keeping.
• Knowledge of medical terminology, insurance procedures, and referral processes.
• Ability to maintain patient confidentiality and adhere to HIPAA regulations.
• Adaptability and flexibility to handle changing priorities and work independently or as part of a team.
• Strong computer skills including MS Word and Excel.
• Able to work with people from diverse ethnic, cultural, and socioeconomic backgrounds.
• Bilingual English/Spanish preferred.

Employee Benefits

• Competitive pay and a robust benefits package that includes:
• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!