Referral Coordinator

SUMMARY

Processes referrals to Specialist through to completion. Ensures accurate, timely review and processing of authorizations.

DUTIES & RESPONSIBILITIES

Receives and Processes incoming referral requests daily.

Reviews referral orders for accuracy of codes and supporting documentation.

Receives, processes, and verifies accuracy of authorizations.

Receives and processes specialty notes to primary care physician to facilitate on-going authorizations for continued care.

Serves as liaison and authorization resource to clinic staff, outside medical groups, and patients.

Ensures pre-visit information is sent to patients as needed.

Utilizes exceptional customer service skills in performing duties and assists with problematic referral and authorization process.

Recommends improvements to department processes as appropriate.

Contacts insurance company(s) to verify patient eligibility if needed.

Contacts patients as needed to update demographics. Informs patients/guarantors of their financial responsibility for scheduled services.

Informs patients and/or clinic the staff of any insurance problems affecting future services.

Develops and maintains professional working relationships with outside providers, vendors and insurance groups involved in the referral process.

Maintains an accurate and up-to-date tracking system for referrals and authorizations. Prepares reports regularly.

Maintains current referral forms and insurance resource materials.

Performs general clerical duties including, but not limited to, typing, answering the telephone, monitoring incoming faxes and assisting scheduling department.

Other duties as assigned. Requirements

MINIMUM QUALIFICATIONS

Education/Certification

High School Diploma or GED.

One year experience in an Ambulatory Care setting. Skills/Experience

Demonstrated problem solving and time management skills.

Computer Skills with high data entry accuracy.

Demonstrated organizational and prioritization skills.

Knowledgeable of referral, payor sources and authorization processes.

Knowledge of CPT and diagnosis codes.

High level data entry and detail oriented.

Excellent Communication skills to effectively communicate with members, physicians, co-workers and supervisors. Preferred Qualifications

Experience as a referral coordinator in an Ambulatory Health Care setting.

Experience with electronic health records.

Bilingual

Salary Description

$17.00 - $24.00 per hour