Referral Coordinator/Full Time/Days

40 hours/week on day shift. Location: Lancaster, PA.

Position Summary

Plans, organizes, directs and coordinates all aspects of the referral office.

Responsibilities

• Coordinates and monitors daily work flow processes and activities for meeting required referral insurance deadlines within 72 hours or as directed by provider - e.g., Stat emergent.
• Daily reviews and monitors referral work que in order to provide accurate and timely referral process documentation.
• Serves as the first-line resource for all customers internal external with regards to Insurance and Referrals. Must be knowledgeable in all areas of insurance verification and authorization referral processes.
• Maintain accurate and current referral log on all patients.
• Serve as liaison for patient with doctor offices with regards to processing referrals. Communication may be via fax telephone electronically.
• Review and analyze managed care patient visits and ensure proper documentation of required services.
• Coordinate internal functions and recordkeeping related to managed care organizations to meet compliance.
• In collaboration with staff in LG Patient Financial Services, ascertain physician credentialing is current and required documentation on file.
• Organizes in-service programs for staff regarding all referral insurance process changes and updates.
• Liaison between patient and insurance company to explain to patient what their insurance company requires to meet referral authorization compliance.
• Must have the ability to communicate in a positive, customer service manner when communicating with all customers or when using Department tools i.e., telephone, fax, email, voice mail, etc.
• Exhibits teamwork and excellent customer service skills without exception, at all time for both internal and external customers.
• Collaboratively works with internal external LG staff, other physician offices, and outside agencies, to resolve patient questions and complaints regarding referral insurance issues.
• Maintains knowledge of registration and scheduling processes with the capability of filling in as needed based on office workload or staffing demands.
• As needed, assist Billing Coordinator with assigned tasks.
• Provide educational sessions to resident physicians and staff.
• Identifies any system dysfunction or discrepancies and reports to Supervisor Manager, making recommendations for improving current department and hospital-wide procedures.
• Assist with other projects or responsibilities as required by Supervisor Manager.
• Addresses gaps in care in an attempt to help patients reconcile any remaining health care screenings or surveillances.
• May outreach to patients who expresses a desire for a new LGHP PCP to schedule an appointment. Outreaches to patients who have not been seen within the prior 18 months at their LGHP PCP office and schedules patients accordingly to maintain their LGHP relationship.
• Other duties as assigned.

Minimum Required Qualifications

• High school diploma or certificate
• One 1 year of computer experience
• One 1 year clerical or clinical experience in a medical practice setting
• One 1 year experience in medical referral insurance
• Basic keyboarding ability and telephone interpersonal etiquette is required.
• Successful completion of customer service training module or commensurate experience with successful completion of related competency testing is also required

Preferred Qualifications

• One 1 year of using medical terminology

Benefits

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region.