REFERRAL COORDINATOR

PURPOSE:  Supports practice revenue and patient satisfaction goals by processing and coordinating all patient referrals for specialty services.

EDUCATIONAL REQUIREMENTS:  High School diploma or equivalent experience

EXPERIENCE:  One year medical office billing experience.

ACCOUNTABILITIES:                                                                                                                                                                                                                               

• Facilitates timely reimbursement by obtaining complete and accurate information on referrals needed for claims submission.  
• Supports patient satisfaction goals by responding referral questions in a prompt and courteous manner.                      
• Follows protocols for proper authorization and processing of referrals, maintaining a tracking system to promote timely completion and / or follow up.
• Communicates with staff regarding any issues or any need of follow up regarding acquiring appropriate documentation for referrals.
• Communicates with the patient on a timely basis to ensure referrals are received and entered for scheduled appointments.
• Communicates with insurance companies and physician offices in order to obtain necessary insurance referral information. 
• Completes all administrative functions associated with referral activities in a timely manner.
• Enters all referral, hospital, outpatient, DME and other patient specialty health services authorizations into computer system according to policies and procedures.
• Contributes to team efforts by assisting other departments at the direction of her/his manager or team lead.
• Participate in educational and professional development activities consistent with business needs.
• Maintain strictest confidentiality of medical/company information, being  knowledgeable and following  all HIPAA Regulations          
• Perform related work as required.                                                                                                                                                           

KNOWLEDGE:

• Familiarity with HIPAA, insurance regulations, policies, procedures and other regulatory policies
• Knowledge of common safety hazards and precautions to establish a safe working environment
• Medical office procedures, policies, practices and medical terminology, telephone protocol and professional etiquette
• Electronic medical systems is a plus, including Athena/Centricity

Qualifications:

• Able to react calmly and effectively under stress
• Ability to interpret, adapt and apply guidelines and procedures
• Develop and maintain effective and professional working relationships with patients, medical staff, coworkers and the public by displaying sympathy, tact and understanding
• Must be a team player with a positive attitude, adjust to various personalities , work with a diverse population, demonstrating patience and professionalism
• Promotes teamwork through collaboration
• Represents the clinic in a professional manner
• Able to maintain strict confidentiality on all patient issues