Referral Coordinator
 

FLSA Class: Non exempt
Department:
Administrative Support
Job Category:
Administration
Reports to:
Practice Manager

Summary Description: The Referral Coordinator processes all medical referrals and coordinates the referral process within the practice. In addition, this position provides support on a regular basis to the front desk by greeting patients and managing flow of visitors into the office.

Essential Functions: To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Expedite patient referrals to specialty offices, fax medical records, answer patient and specialty office inquiries, and complete referral requests.
  • Verify eligibility, dates of coverage, and benefits for specialty services.
  • Communicate, problem solve and prioritize issues with patients, external specialists, practice providers, and health plans as appropriate.
  • Develop and maintain working relationships with specialists and diagnostic facilities to facilitate patient scheduling.
  • Process referrals within guidelines related to referral productivity thresholds and turn‐around times.
  • Update referral database.
  • Communicate approval or denial of referral authorization to patient and referring provider.
  • Identify patients that may be eligible for case management services outside practice.
  • Provide support at front desk, including: greet and check‐in patients; schedule and reschedule appointments; screen calls; notify medical staff of patients’ arrival; assists patients and family with instructions, directions, and information; directs phone calls and/or leave messages for very busy medical staff in EMR system; obtain sufficient information for billing; and collect on patient balances and receives co‐pays.
  • Attend required meetings and participates in training programs as required.
  • Understand and adhere to HIPAA policies, procedures and regulations to ensure and maintain patient confidentiality.
  • Assist with miscellaneous office duties as needed.

Education: 

  • High school graduate or equivalent required.
  • Associates degree or equivalent experience preferred.
  • At least 3 years Electronic Medical Record/Patient Scheduling systems experience.

Job Requirements:

  • Two plus years’ experience in a medical setting, internal or family medicine preferred.
  • Must possess excellent customer service skills, including verbal and written communication and interpersonal skills with patients, staff and other healthcare professionals.
  • Understanding of insurance verification and co‐pays required.
  • Knowledge of various medical insurance plans; including co‐insurance, deductibles, and
    out‐of‐pocket.
  • Ability to solve problems possesses sound and accurate judgment.
  • Ability to set priorities and handle demanding schedules.

Computer Skills:

  • Microsoft Office Suite.
  • Electronic Medical Record/Patient Scheduling systems

Supervisory Responsibility: None

Competencies:

  • Communications - Expresses ideas and thoughts verbally. Expresses ideas and thoughts in written form. Exhibits good listening and comprehension. Keeps others adequately informed. Selects and uses appropriate communication methods.
  • Customer Service - Displays courtesy and sensitivity. Manages difficult or emotional customer situations. Meets commitments. Responds promptly to customer needs. Solicits customer feedback to improve service.
  • Dependability - Responds to requests for service and assistance. Follows instructions, responds to management direction. Takes responsibility for own actions. Commits to doing the best job possible. Keeps commitments. Meets attendance and punctuality.
  • Planning & Organization - Prioritizes and plans work activities. Uses time efficiently. Plans for additional resources. Integrates changes smoothly. Sets goals and objectives. Works in an organized manner.
  • Quality - Demonstrates accuracy and thoroughness. Displays commitment to excellence. Looks for ways to improve and promote quality. Applies feedback to improve performance. Monitors own work to ensure quality.
  • Use of Technology - Adapts to new technologies. Demonstrates required skills. Keeps technical skills up to date. Troubleshoots technological problems. Uses technology to increase productivity.

Work Environment: This job operates in a professional office environment. This role routinely uses
standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Work is typically indoors. The noise level in the work environment is usually moderate.

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

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger,
handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to
stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Travel: No travel is expected for this position.

Other Duties: This job description is not intended to cover or contain a comprehensive listing of activities, duties, standards or responsibilities that are required of the employee for this position. Duties, responsibilities and activities may change at any time with or without notice. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.

 

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