Referral Coordinator

Description

Position Summary:

The referral coordinator is responsible for referral operations at assigned clinics, establishing and standardizing systems and procedures for distributing and using health information throughout the organization and coordinating referral functions with all other departments.

Responsibilities:

•  Ensures current and standardized referral policies and workflows. 
• Prioritizes referrals by their urgency and addresses them in a timely manner. 
• Participates in the selection, orientation, and training of referral personnel. 
• Ensures complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
• Contact insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis, and prognosis to insurance companies if deemed necessary to prove the medical necessity of services.
• Review details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable. 
• Develops and implements systems as EMR functionality and/or regulatory agencies require. 
• Identifies and utilizes community resources; establishes relationships with servicing providers and personnel. 
• Point of contact for patients and specialists for any questions or raising concerns. Assisted in problem-solving potential issues related to their referral.
• Assists with daily patient billing calls 
• Responsible for complete billing workflow for all worker’s comp claims 

Other duties as assigned. 

Requirements

Education / Experience:

• High school diploma required. An associate degree in accounting, finance, or a related field is preferred. 
• Proven experience in billing, invoicing, or accounting.  
• Strong attention to detail and numerical accuracy. 
• Excellent communication and interpersonal skills. 
• Strong problem-solving and analytical abilities. 
• Ability to work independently and as part of a team. 
• Time management skills and the ability to prioritize tasks effectively. 
• Experience in medical billing or related field preferred 

Physical Demands and Work Environment:

The physical demands described here represent those that must be met by an employee to perform the essential functions of this position successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. The physical demands described here represent those that must be met by an employee to perform the essential functions of this position successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to work inside a clean, well-lit work environment. While performing the duties of this position, the incumbent is regularly required to talk or hear. The employee must frequently use hands or fingers to handle or feel objects or controls. The employee is occasionally required to stand, walk, sit, reach with hands and arms, climb or balance, and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities this position requires include close vision, distance vision, color vision, peripheral vision, and the ability to adjust focus. The noise level in the work environment is usually moderate. The employee may be required to travel to various locations.