Bilingual Referral Coordinator

The job overview for the Referral Coordinator role is to facilitate care coordination and effective member co-management for behavioral and non-behavioral practitioners. The coordinator is responsible for prioritizing patient cohorts, scheduling appointments with preferred specialists, ensuring missed appointments are rescheduled, and completing documentation based on standardized protocols. They also handle the exchange of information between specialists and ensure the completion of referrals for inpatient and outpatient procedures, as well as home health and DME orders. The coordinator may also address referral-based phone calls.

• Prioritizes assigned patient cohorts to ensure specialty referral completion and ensures stat and expedited referrals are completed based on timeliness standards
• Schedules patients (Preferred Providers List of Specialists) and notifies them of appointment information, including, date, time, location, etc.
• Ensures missed specialty appointments are rescheduled and communicated to the physician/clinician.
• Ensures specialist notifications of referral status
• Completes exchange of information by retrieving and ensuring upload of specialty consultation and follow-up notes
• Completes documentation based on standardized documentation; to include, but not limited to location, notification of specialist, notification of patient, status of appropriateness reviews
• Enters all Inpatient and Outpatient elective procedures in EMR and contacts specialist for post-procedure referral needs
• Follows up on all Home Health and DME orders to ensure the patient receives the services ordered.
• Completes appropriateness review based on clinical protocols and appropriately refers to Nurse or Medical Director
• Addresses referral based phone calls for

• Prioritizes assigned patient cohorts to ensure specialty referral completion and ensures stat and expedited referrals are completed based on timeliness standards
• Schedules patients (Preferred Providers List of Specialists) and notifies them of appointment information, including, date, time, location, etc.
• Ensures missed specialty appointments are rescheduled and communicated to the physician/clinician.
• Ensures specialist notifications of referral status
• Completes exchange of information by retrieving and ensuring upload of specialty consultation and follow-up notes
• Completes documentation based on standardized documentation; to include, but not limited to location, notification of specialist, notification of patient, status of appropriateness reviews
• Enters all Inpatient and Outpatient elective procedures in EMR and contacts specialist for post-procedure referral needs
• Follows up on all Home Health and DME orders to ensure the patient receives the services ordered.
• Completes appropriateness review based on clinical protocols and appropriately refers to Nurse or Medical Director
• Addresses referral based phone calls for

• High School Diploma required
• Minimum 2 years of experience in medical management
• Capacity to interpret health plan benefit decisions
• Certification as a Medical Assistant preferred
• Work performed in an open office setting
• Detailed work sitting at a desk/table and working on the computer
• Some travel may be required
• Equal Opportunity Employer
• Diverse employee group
• Consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law