Position Title: Referral Coordinator

Reports To: Supervisor, Referral Specialist

Department: Referral Services

FLSA Status: Non-Exempt

Job Summary:

The Referral Coordinator supports the clinical unit with clerical activities. This individual will coordinate all external and some internal services and will be responsible for scheduling consultations, diagnostic testing and surgical procedures. The ideal candidate inputs referrals and authorizations into a data bank and coordinates follow-up care with the referral physicians as approved by a Physician Associates physician. The Referral Coordinator will also coordinate all related services in a pleasant and professional manner for patients as directed.

Essential Duties & Responsibilities:

• Responsible for order entry into the computer system.
• Coordinates and schedules referrals when necessary per policy.
• Ensures that all necessary medical records are forwarded to referral provider.
• Acts as a resource for staff and patients with questions regarding referral policies and procedures. Provides internal and external referral coordination.
• Inputs all authorization information into data base including, diagnostic and procedure codes. Will obtain appropriate authorizations as needed.
• Refers requests for emergency care and urgent care or medical advice to the appropriate staff member.
• Acts as a resource for staff and patients with questions regarding insurance benefits.
• Contacts patients with information concerning tests ordered by a provider as necessary.
• Orders and/or directs patients for outside tests.
• Helps to maintain daily flow by assisting Supervisor as directed.
• Works effectively as a member of a patient care team and contributes suggestions for improving unit and organization operations. Completes other tasks as assigned.
• He/she will obtain authorization from a diversity of insurance companies depending on each patient’s insurance plan

Additional Duties & Responsibilities:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Supervisory Responsibilities:

No supervisory responsibilities.

Education & Experience:

• High school diploma or GED.
• Previous experience in a physician’s office, clinic or hospital processing referrals.
• Medical terminology knowledge.
• Experience scheduling healthcare appointments.
• Experience with office equipment, including computers, calculators, fax machines and copiers.

Knowledge, Skills & Proficiencies:

• Bilingual in English and Spanish
• Proficient on Microsoft office
• Proficient in use of eCW
• Experience in different Insurance portals
• Medicaid and Medicare knowledge

Tools & Equipment Used:

Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

Physical Requirements/Working Environment:

This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Travel:

Work may involve some driving/traveling to assigned clinics.

Disclaimer:

The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties and responsibilities to this job at any time.