Medicare Referral Coordinator

ChenMed•Mount Airy, NC

22d•$17 - $24•Onsite

About The Position

We are a unique and rapidly expanding healthcare organization dedicated to transforming lives for both our patients and our team members. We are seeking innovative and ambitious individuals with exceptional work ethics and a passion for inspiring others. As a Care Coordinator, you will play a crucial role in our patient-focused environment, working directly with our patient population and their families. Your responsibilities will include authorizing, scheduling, and ensuring the completion of patient visits with specialty care. This involves collaborating with insurance representatives, outside vendors, arranging transportation, and communicating with physicians, clinicians, and other medical personnel to ensure successful completion of approved referrals.

Requirements

High School diploma or equivalent required.
A minimum of 1 year of referral experience in a healthcare setting required.
Spoken and written fluency in English.

Nice To Haves

Knowledge of medical terminology, CPT, HCPCS and ICD coding desired.
An understanding of the company's patient population, including the complexities of Medicare programs.
Exceptional organizational skills with the ability to effectively prioritize and complete tasks in a timely manner.
Detail-oriented with the ability to multi-task.
Able to exercise proper phone etiquette.
Ability to navigate proficiently through computer software systems & use technology.
Ability to work well with patients, colleagues, physicians and other personnel in a professional manner.
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
Bilingual preferred.
Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
Healthcare experience within the Medicare Advantage population preferred.
Medical Assistant certification preferred.
CPR for Healthcare Providers is preferred.

Responsibilities

Serve as the primary point of contact for incoming and outgoing patient referrals.
Triage referrals, gather necessary information, ensure timely processing, and assign to appropriate providers.
Facilitate communication, collaboration, and coordination of care.
Coordinate appointments, referrals, and transitions of care between primary care, specialists, hospitals, and other healthcare settings to ensure seamless transitions and continuity of care.
Schedule patients using the coordinated provider list (CPL), make necessary arrangements for appointments, and notify patients of appointment details (date, time, location).
Utilize web-based insurance platforms to generate referral authorizations.
Effectively communicate physicians'/clinicians' needs or outstanding items to patients.
Follow all referrals through to completed appointments, obtain all related documentation, and upload it into the organization’s medical record system for physician review prior to PCP follow-up appointments.
Ensure any missed external appointments are rescheduled and communicated to the PCP.
Address referral-related phone calls from patients, providers, etc.
Complete and address phone messages in a timely manner.
Provide extraordinary customer service to all internal and external customers.
Perform other related duties as assigned.