Referral Coordinator

JOB SUMMARY 

The role of the Referral Coordinator is to facilitate consistency of information shared across practices to promote care coordination and effective member co-management for behavioral and non-behavioral practitioners.  

DUTIES & RESPONSIBILITIES 

The Referral Coordinator job description is intended to point out major responsibilities within the role, but it is not limited to these items. 

• Prioritizes assigned patient cohorts to ensure specialty referral completion and ensures stat and expedited referrals are completed based on timeliness standards. 


• Schedules patients (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc. 


• Ensures missed specialty appointments are rescheduled and communicated to the physician/clinician. 


• Ensures specialist notifications of referral status. 


• Completes exchange of information by retrieving and ensuring upload of specialty consultation and follow up notes. 


• Completes documentation based on standardized documentation; to include location, notification of specialist, patient notification, status of appropriateness reviews. 


• Enters all Inpatient and Outpatient elective procedures in EMR and contacts specialists for post-procedure referral needs. 


• Follows up on all Home Health and DME orders to ensure patient receives services ordered. 


• Completes appropriateness review based on clinical protocols and appropriately refers to Nurse or Medical Director 


• Addresses referral-based phone calls for Primary Care Physicians panel and completed phone messages timely. 


• Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned. 

EDUCATION AND PROFESSIONAL EXPERIENCE 

• High School Diploma 


• Minimum 2 years of experience in medical management, preferably with referral coordination.


• Certification as a Medical Assistant preferred.  

PROFESSIONAL COMPETENCIES 

• High level of critical thinking and problem-solving skills 


• Strong work ethic and overall positive attitude 


• Effective communication skills including verbal and written. 


• Ability to manage time effectively, understand directions, and work independently in a fast-paced environment. 


• Demonstrated flexibility, organization, and self-motivation. 


• Highly adaptable to change.