Referral Coordinator

PRIMARY PURPOSE:

Managing the referral process efficiently to ensure patients and caregivers receive timely and appropriate specialist care. Plays a fundamental role in the healthcare system in facilitating seamless communication between patients, primary care providers, specialists and insurance companies.

ESSENTIAL JOB FUNCTIONS:

Referral Coordination:

• Managing patient referrals to specialists and other healthcare providers.
• Obtaining insurance authorization while verifying that the insurance is still active.
• Scheduling appointments, if needed, to coordinate patient visit care.
• Maintain accurate referral tracking and documentation for patient safety.
• Gather and provide relevant clinical background to specialists, per referral guidelines.

Insurance & Financial Navigation:

• Obtain insurance authorization if needed.
• Prompt follow-up on all referrals and track progress.
• Communicating with providers to close referral loops and ensure proper documentation.
• Update record to reflect completed referrals and outcomes.

Patient Support & Communication:

• Review referral details and expectations with patients.

Administrative & Compliance Duties:

• Ensure adherence to HIPAA confidentiality standards to protect patient information.
• Follow healthcare regulations to maintain ethical and legal compliance.
• Implement best practices for secure communication and data handling.
• Stay updated on emerging professional information.
• Comply with all FoundCare policies and procedures.

MINIMUM QUALIFICATIONS:

Education:

• College degree (preferred: Bachelor’s in Health Services Administration or Health Science).

Experience:

• Minimum of one (1) year assisting patients with medical referrals.
• Type minimum of 30 words-per-minute.
• Proficiency in Microsoft Outlook, Word, and Excel.
• Referral experience with an electronic medical record (EMR) system is preferred.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

• Strong verbal and written communication.
• Excellent organization and time management.
• PC proficiency.
• Attention to detail.
• Ability to build rapport with patients, providers, and staff.
• Strong customer service orientation.
• Strong leadership and program management skills.
• Ability to multitask, work independently, and collaborate as part of a team.
• Ability to read, write, and effectively communicate in the English language, with or without the use of auxiliary aids or services.
• Ability to review, understand, and apply concepts presented in training programs, conferences, and/or professional literature.
• Educated on and compliant with HIPAA regulations; maintains strict confidentiality of client information.
• Ability to interact and work with diverse populations.

PHYSICAL REQUIREMENTS:

• Ability to endure short, intermittent, and/or long periods of sitting and/or standing in performance of job duties.
• Full range of body motion required. Position requires reaching, bending, and handling objects with hands and/or fingers, talking and/or hearing, and seeing.
• Ability to lift and carry objects weighing 25 pounds or less.
• Accomplish job duties using various types of equipment/supplies, e.g. pens, pencils, calculators, computer keyboard, telephone, etc.
• Ability to travel to other FoundCare locations and perform job duties.
• Ability to travel to other locations to attend meetings, workshops, and seminars, plus travel to other FoundCare departments and FoundCare conference rooms.