OBJECTIVE SUMMARY: Referral Coordinator is responsible for obtaining all prior-authorizations for outgoing specialist visits, procedures, and testing. The referral coordinator will be responsible to ensure all incoming referrals for office visits, procedures and testing have been authorized. Additionally, the referral coordinator’s responsibilities include appointment coordination, patient communication, scheduling appointments, registering patients. The referral coordinator will work together with other departments and/or organizations to assure all necessary patient information is provided and/or obtained and in electronic format whenever possible. The referral coordinator will be responsible to ensure all patient referrals are monitored for loop closure; all patients follow through with appointment attendance and consultation notes have been received or sent.
Processes all diagnostic/specialty/miscellaneous outbound referral requests from providers
Obtains authorization for outbound referrals and schedules appointments as appropriate
Monitors all incoming referrals for authorization
Works with outside referring provider offices
Records all appropriate referral information in patients chart
Provides all necessary patient information (medical records, notes, etc.) to the appropriate source remembering the importance of confidentiality and HIPAA.
Obtains all necessary records from outside provider offices
Assists with chart abstraction from paper to electronic when applicable
Scans and files correspondence into the electronic medical record for provider to review and sign off
Handles incoming calls regarding referrals/authorizations and takes appropriate action based on those calls
Appropriately closes the loop on all outbound and incoming referrals; ensures patient obtained care, records were sent or received and documents actions as directed
Assists patient in obtaining care when a referral has not been completed
Assists with assigned projects
Demonstrates an understanding of practice management system’s patient processing functions through an ability to enter data with minimal direction or assistance when assisting reception
Performs other duties as assigned
REQUIRED EDUCATION: High School Diploma or GED
PREFERRED EDUCATION: Associates Degree
REQUIRED EXPERIENCE: One year medical record experience; exposure to insurance verification and referral authorization fundamentals
PREFERRED EXPERIENCE: At least one year as a referral coordinator in a medical practice
General knowledge of medical insurance processes
Knowledge of medical terminology, CPT & ICD codes
Ability to communicate effectively, both written and orally
Excellent customer service skills
Ability to cross train in other areas of practice in order to achieve smooth flow of operations
Good organizational skills with the ability to adapt to medical situations
Ability to handle patient and organizational information in a confidential manner
Ability to work in an environment of continuous change
Ability to manage priorities and work under deadlines
Speaks and understand the English language
Good working conditions. Clean, well-lighted, temperature controlled area.
No chemical exposures other than usual healthcare environment cleaning products
Sitting, standing, and walking over course of work day
No lifting over 5 pounds
Extended times of computer work
OTHER DUTIES – Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
* High school diploma or GED. * Exposure to insurance verification and authorization fundamentals. * One year medical record experience.
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