Referral Coordinator - Special Medicine Clinic

Division:Eskenazi Health

Sub-Division: Hospital

Req ID: 19743

Schedule: Full Time

Shift: Days

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status

Non-Exempt

Job Role Summary

The Referral Coordinator processes referrals for patients seen in the Eskenazi Health Center. This includes: verifying patient insurance eligibility; communicating with physicians; obtaining prior authorization or precertification when needed; scheduling appointments consistent with patients' insurance plan, and processing all appropriate paperwork. The Referral Coordinator communicates appropriate diagnostic and clinical information as needed. The Referral Coordinator communicates with all patients in a manner appropriate to their age and development stage.

Essential Functions and Responsibilities

Serves as patient information liaison between hospitals, insurance companies, physician offices and other departments.

Processes referrals in a timely manner.

Processes referral instructions from providers and obtains appropriate appointments.

Reviews patients' insurance information to ensure provided services are scheduled within the appropriate provider network.

Provides accurate diagnosis and clinical information to provider of referred services.

Provides education and clarification to patients regarding their insurance coverage as appropriate.

Completes and processes appropriate paperwork in accordance with specific insurance requirements.

Maintains accurate referral records.

Responds to/facilitates inquiries from patients, physicians, insurance companies and area hospitals regarding benefits/referrals, etc. in a timely manner.

Establishes effective working relationships with other specialty offices.

Stays current with insurance and system updates.

Regularly attends required meetings.

Adheres to State and Federal safety guidelines.

May be required to assist with PSA functions.

Responsible for own professional growth.

Job Requirements

High School diploma or equivalent (GED) recommended.

One year experience in health care setting required.

One year experience working with multiple insurance plans and networks preferred.

Must pass multiple system application exams as applicable.

Medical terminology knowledge preferred.

Knowledge, Skills & Abilities

Knowledge of hospital and clinic processes and procedures.

Working knowledge of multiple insurance plans and networks.

Knowledge of medical terminology.

Knowledge of IC D-9/C PT coding.

Basic computer knowledge and skills with typing speed of 30 wpm.

Alpha/numeric filing skills.

Strong organizational skills.

Well-developed problem-solving skills.

Effective oral/written communication skills, including the ability to communicate with patients in a manner conducive to the patient's age and developmental stage.

Ability to:

operate standard office equipment

read and understand insurance cards

relate in a professional and courteous manner to patients and staff

prioritize work and devise own work patterns/methods and manage large work volumes

be flexible to changing work duties and priorities

exercise good judgment and work with minimal supervision

be detail-oriented

follow oral/written instructions

interact with patients from all economic, educational, and social backgrounds

Treat all patients with dignity and respect

Accredited by The Joint Commission and named as one of Indiana’s best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.