We are looking for an organized Referral Coordinator to undertake all referral and authorization requests from our physicians. You will be the go to person for our patients who are in the need of referrals, authorization, and in some cases, timely appointments with specialists and other ancillary providers.
The ideal candidate will have a patient and cheery demeanor while also being very organized and able to multi-task. You should be able to provide services in a timely manner while maintaining lines of communication between the patient and the provider. A customer-oriented approach is essential.
The goal is to complete referrals and authorization requests in a timely manner according to physician instructions.
We are a geriatrics office, specializing in Medicare Risk.
Referral coordination includes the following activities:
- Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety. This tracking is achieved through logs.
- Ensure complete and accurate outgoing referral and authorization requests, including patient demographic and current insurance information.
- Assemble information concerning patient’s clinical background and referral needs. Per internal referral guidelines, provide appropriate clinical information to specialist and diagnostic centers.
- Review cases with providers to ensure prior approval requirements are met.
- Collect and present necessary medication information such as history, diagnosis and prognosis.
- Contact review organizations and insurance companies to submit initial requests for authorization of medical services.
- Conduct follow-up to requests for medical services and authorizations for such services.
- Review details and expectations about the referral with patients.
- Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
- Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
- Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
- Ensure that referrals are addressed in a timely manner.
- Remind patients of scheduled appointments via mail or phone.
- Ensure that patient’s primary care chart is up to date with information on specialist consults, diagnostic testing results, and ancillary services related to their health.
- Complete tasking on assigned HEDIS reports and follow-up to ensure timely patient completion of requested services.
- Will work out of assigned office, however, may be required to occasionally assist at other locations.
The following experience and skills are important:
- High school diploma
- Strong customer service focus
- Effective verbal and written communication skills
- Teamwork orientation
- Organized and able to manage competing priorities
- Good judgment
- Resourcefulness in problem solving
- Able to take and follow through with delegated tasks and accountability
