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The Referral Coordinator works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits and diagnostic imaging. Responsibilities include: processing referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement; scheduling; and, notifying patients of upcoming appointments.
Essential Functions:
Gathers, verifies and processes referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers
Communicates detailed information and answers patients’ questions regarding their health care plan; provide answers to billing and insurance clarification questions
Sets up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.
Coordinates flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient
Enters referrals, documents communication and action into the system, as appropriate
Notifies physician(s) and patient when referral is denied, or if additional information is needed
Develops and maintains database of referral physician offices preferred by each physician within the clinic
Assists Practice Manager with complaint resolution and solutions related to patient referral
Shift Requirements:
Shift Length (in hours): 8 hours
# Shifts/Week: 5
Overtime Required: ☐ Infrequently ☐ Sometimes ☐ Often ☐ n/a (exempt position)
Other Functions:
Promptly and professionally answers telephones calls
Fulfills clerical responsibilities as assigned
Maintains compliance with all company policies, procedures and standards of conduct
Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
Performs other duties as assigned
Education:
Experience:
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