Referral Coordinator

Position Summary:  

The referral coordinator activities will involve, but not limited to, assist patients in obtaining approval for referral, scheduling appointments and managing health insurance issues in a timely manner. As a referral coordinator, you work directly with the patient, patient families, adjustors, insurance companies, provider/specialty offices and others as needed depending on the referral and patient needs. Acts as a liaison for the patient to coordinate and complete the entire referral process. 

Duties and Responsibilities: 

• Maintains referral log and verified that patient referrals are completed; verified the receipt of referral notes and/or follows up with provider/specialist office if needed. 
• Ensure complete and accurate registration, including patient demographic and current insurance information. 
• Obtains insurance pre-certification and authorization required by various insurance plans. Checks to make sure that procedures are covered by the patient’s insurance and confirm patient out of pocket cost for each visit. 
• Responds to internal and external needs and requests in a positive manner, utilizing the principals of the AIDET model; exceeding their needs and expectations and providing the highest quality service to ensure the best possible outcomes. 
• Strong customer service focus, effective verbal and written communication skills and teamwork. 
• Review details and expectations about the referral with patients. Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance). 
• Scan and file in patients EHR file all results/communication received from the specialists, hospital or provider office. 
• Able to take and follow through with delegated tasks and accountability. 
• Follows the Xpress Wellness guidelines related to HIPAA, designed to prevent or detect unauthorized disclosure of PHI and always maintains patient confidentiality. 
• Participate in Quality Improvement projects as assigned. 
• In addition to supporting referral activities, also provide general administrative and clerical support to the clinic. These tasks can include answering phone calls and emails, managing schedules, and maintaining electronic or paper files and records. 
• They may also check to make sure doctors and nurses have necessary supplies and patient records prior to appointments. 

Qualifications: 

Education: 

• High School Diploma or equivalent. 
• Experience: 
• 2 years medical office experience or health insurance field preferred but not required. 

Skills: 

• Excellent oral and written skills. Communicates prompt and clearly. 
• Strong organizational skills and attention to detail, deadlines and compliance. 
• Ability to maintain patient confidentiality at all times. 
• Knowledge of guidelines related to the Health Insurance Portability and Accountability Act (HIPAA) 
• Knowledge of basic medical terminology. 
• Ability to react to change productively and handle essential tasks as assigned. 
• Ability to work independently without direct or minimum supervision.
• Ability to multitask and monitor several projects and accounts on a daily basis. 
• Ability to work under pressure and manage time effectively. 
• Ability to establish and maintain relationships with service providers. 
• Basic computer literacy skills including but not limited to EMR, MS word and MS excel.