Job Title : MCE Referral Coordinator

Location : US-FL-Boca Raton

Overview :

The company is seeking a Healthcare Referral Coordinator to provide administrative support and assistance for the Medical Centers of Excellence (MCE) Program by facilitating communication, compiling necessary documentation, and communicating with the member and other approved parties

Additional duties include varying administrative support functions, customer service excellence which includes an emphasis of adhering to high quality and compliance standards set by regulatory bodies and in accordance with departmental standards.

Coordinator Responsibilities :

Organize all pertinent data / materials to securely transfer to the appropriate person(s) and ensure their receipt as well as maintain accurate documentation to ensure true data integrity.

Submit referrals and documentation to designated MCE facilities adhering to HIPAA and privacy regulations

Ensure follow-up is completed within the specified timeframe in accordance with the MCE process guidelines.

Prioritize work to ensure timeliness of the referral process and various touch points or tasks.

Initiate and maintain contact with the member and affiliated physician or office staff to ensure that all parties are aware of the referral process and each step along the way.

Provide the member with a thorough explanation of the referral process, as well as the selected facilities??? process.

Confirm appointment dates and times prior to the member???s appointment with both the member and the affiliated physician or office, as well as confirm with the member if any additional assistance is needed.

Contact all members following their appointment to inquire about their experience and to receive approval to send a member MCE Program satisfaction survey.

Coordinate and schedule teleconferences, as needed, between MCE specialty physician and general physicians.

Ensure any pre or post appointment requests as related to medical recommendations or reports are forwarded to the physicians in a timely matter and adhere to department protocols.

Administrative Responsibilities :

Draft and prepare correspondences to be reviewed and approved by management when applicable.

Prepare / mail approved correspondence to members, insurance companies, diagnostic centers via Federal Express, certified return receipt, or standard mail.

Answer telephones, faxes and scans documents, assist with reception duties, as needed.

Prepare and update appropriate reports or presentations as needed.

File and maintain electronic filing system.

Follow up with physician offices to guarantee documentation is delivered after member???s appointment with the specialist.

Provide administrative support to the Insurance Services department, as needed.

Maintain data integrity by notating appropriate application systems and following through on tasks.

This job profile is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee

Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Qualifications :

Education / Experience / Knowledge :

Associate's degree (A

A.) from two-year College or university and 3 years related experience and / or training; or equivalent combination of education and experience where two years of related experience equals one year of schooling.

Demonstrated knowledge of medical terminology, insurance products, and health care coverage is needed.

Customer service and administrative experience

Experience working with Physicians and patients.

Knowledge of medical conditions, and familiarity with the referral process, is preferred.

Computer Proficiency :

Advanced knowledge of Microsoft applications including : Word, Excel, PowerPoint, Publisher, Outlook, SharePoint, document storage systems, as well as Internet Explorer and Adobe Software.

Able to learn new software easily.

Corporate office role : As a corporate based role in Boca Raton, FL, employees are expected to work from the corporate office

This role may be eligible for a hybrid in office / work from home schedule based on department needs after 90 days of employment.

Benefits - 401K 6% match, 13 days PTO, 3 floating holidays, 9 regular holidays.

Last updated : 2024-04-29