Referral Coordinator
Job Description
Good oral and written communication skills are required for this position. Information must be exchanged using tact and persuasion appropriately. The person in this position must be able to communicate with the patients, staff, and others; and contribute to a positive environment. The ability to communicate in Spanish, Creole, or both is a plus.
Key Responsibilities
-
Maintain professional behavior, and attitude towards patients, visitors, and co-workers.
-
Schedule diagnostic testing and specialty appointments as requested.
-
Documents in patient’s chart accordingly.
-
Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
-
Ensure complete and accurate registration, including patient demographic and current insurance information.
-
Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialists.
-
Complete prior authorization process for diagnostics and specialty services.
-
Contact insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis, and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and/or physicians.
-
Review details and expectations about the referral with patients.
-
Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
-
Ensure that referrals are addressed in a timely manner.
-
Remind patients of scheduled appointments via mail or phone.
-
Follow up on referrals to ensure patients are keeping the appointments as scheduled.
-
Request medical records/reports and tracks to ensure that records/reports are received in a timely manner.
-
Ensure that patient’s chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
-
Document patient contact and progress in the EHR.
-
Attend educational offerings as appropriate.
-
Perform other duties and responsibilities as assigned.
-
May occasionally need to travel from one location to another for coverage.
Education & Training
-
High School diploma or GED required; college degree preferred.
-
Must be cross trained in electronic medical records, scheduling software, and Microsoft Outlook.
Experience
-
One to three years of progressive work experience in a medical office setting
-
Ideally, bilingual, English & either Spanish or Creole
18-20
