Referral Coordinator

Referral Coordinator

Requirements

• Knowledge of medical terminology, CPT, HCPCS and ICD coding desired
• An understanding of the company’s patient population, including the complexities of Medicare programs
• Exceptional organizational skills with the ability to effectively prioritize and complete tasks in a timely manner.
• Detail-oriented with the ability to multi-task.
• Able to exercise proper phone etiquette.
• Ability to navigate proficiently through computer software systems & use technology.
• Ability to work well with patients, colleagues, physicians and other personnel in a professional manner.
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
• Spoken and written fluency in English; bilingual preferred
• High School diploma or equivalent required
• A minimum of 1 year of referral experience in a healthcare setting required.

Responsibilities

• Serve as primary point of contact for incoming and outgoing patient referrals. Triage referrals, gather necessary information, ensure timely processing and assignment to appropriate providers.
• Facilitates communication, collaboration, and coordination of care. Coordinating appointments, referrals, transitions of care between primary care, specialists, hospitals, and other healthcare settings, ensuring seamless transitions and continuity of care.
• Schedules patients utilizing coordinated provider list (CPL), makes all necessary arrangements related to the appointment, notify patients of appointment information: date, time, and location.
• Uses web-based insurance platforms to generate referral authorizations.
• Effectively communicates the physicians/clinicians needs or outstanding items to patients.
• Follows all referrals through to completed appointment and obtains all documentation related to appointment, uploading into organization’s medical record system for physician review prior to PCP follow-up appointment.
• Ensures any missed external appointments are rescheduled and communicated to the PCP.
• Addresses referral-related phone calls from patients, providers, etc. Completes and addresses phone messages in a timely manner.
• Provides extraordinary customer service to all internal and external customers.
• Performs other related duties as assigned.

Preferred Qualifications

• Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
• Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
• Healthcare experience within the Medicare Advantage population preferred.
• Medical Assistant certification preferred.
• CPR for Healthcare Providers is preferred.