Referral Coordinator

Default Work Shift:

Day (United States of America)

Hours:

40

Salary range:

$19.72 - $29.95

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Pulmonary Clinic (Rancho Mirage)

Job Objective:

Coordinates incoming patient referrals, including insurance referrals, and performs front office duties. Ensures all referrals are reviewed and transcribed into Epic; manages assigned work queue(s), including medical records requests, preparation of medical charts, returning phone calls and facilitating physician’s orders in conjunction with clinical staff.

Job Description:

Education:
Required: High school diploma, GED or higher level degree if hired after March 1, 2025

Licensure/Certification:
N/A

Experience:
Required: One (1) year of experience in a clinical/ambulatory care setting
Preferred: Experience with electronic scheduling and insurance/HMO authorizations

Reports To: Manager, Director or Chief Administrative Officer
Supervises: N/A
Ages of Patients: N/A
Blood Borne Pathogens: Minimal/No Potential

Skills, Knowledge, Abilities:

Ability to adapt quickly to changing priorities and unexpected situations, Ability to create a welcoming environment for patients and visitors, demonstrating empathy and respect in all interactions, Ability to effectively communicate in a positive and professional manner, Ability to handle difficult and stressful situations in a calm and professional manner, Ability to operate general office equipment (i.e., computer, printer, scanner, telephone, etc.), Ability to organize information or data to facilitate easy retrieval and use, Ability to successfully complete training orientation program(s) and competencies, Ability to use Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and other relevant software applications, Basic knowledge of insurances, including eligibility and benefit coverage, and other relevant information, Critical thinking skills, Knowledge of Epic scheduling, registration and communication tools, Self-starter; driven to take action without needing prompting, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and reports suspected violations.
2. Manages clinic Electronic Medical Record (EMR) incoming/outgoing referral work queues; facilitates patient appointments or referral to intended clinic accordingly and in a timely manner.
3. Establishes and maintains an open and collaborative relationship with clinics and departments to facilitate a seamless referral process.
4. Answers all patient questions, requests and telephone/written correspondence timely and appropriately to ensure a positive experience.
5. Verifies accurate and complete patient, guarantor and insurance carrier information for billing and follow-up.
6. Submits required documentation to support treatment for referral completion; ensures insurance authorization is received timely.
7. Manages and organizes all outgoing documents sent to central Health Information Management (HIM) for scanning/indexing: ensures proper patient identification on each document and appropriateness of documents to be scanned.
8. Requests and obtains medical record data from referring offices and organizations, as needed.
9. Identifies and collects co-pays/deductibles based on insurance eligibility information and/or EMC uninsured cash discount quotes for emergency and outpatient services; provides patient with receipt of payment, if applicable.
10. Coordinates with clinical staff to obtain medical records to submit to HMO insurance, if applicable.
11. Contacts patients to schedule annual Medicare wellness visits and annual HMO physicals in collaboration with nurse, if applicable.
12. Covers front desk duties; answers phones, retrieves voicemail messages and returns calls timely and appropriately, if applicable.
13. Performs other duties as assigned.