Referral Coordinator/MA

Diabetes & Glandular Disease Clinic, P.A.•San Antonio, TX

About The Position

The Referral Coordinator is responsible for the processing and coordination of patient referrals to help provide the best patient care team. Assists providers and patients, when necessary, with the referral process for specialty care, diagnostic services to ensure continuity of care utilizing the protocols required by various health plans.

Requirements

Knowledge of EMR systems preferably Athena
Knowledge of basic medical terminology
Ability to operate basic office equipment
Proper telephone etiquette
Ability to read, understand and follow oral and written instructions
Must be well organized and detail-oriented
Have the ability to respond well under pressure
Promotes a professional, productive and positive work environment
Knowledge of medical terminology
Familiarity of clinic protocols and policies
Knowledge of HIPAA
Knowledge of EMR, health insurance
Skilled in multitasking effectively and answering multiple phone calls
Skill in conducting cooperative interactions with patients and staff
Skills in prioritizing tasks and time management.
Strong organizational skills
Ability to provide excellent customer service
Ability to interpret and respond appropriately to instructions
Ability to build rapport with patients and co-workers
Ability to recognize the need to escalate calls to manager, nurse or provider as necessary
Ability to exercise sound judgment in handling calls, especially with dissatisfied patients
High School Diploma or equivalent
Minimum of 1-2 years’ experience in administrative medical office setting and Insurance & referral knowledge

Responsibilities

Reviews referrals to confirm or obtain insurance authorization. If no authorization, returns referral to referring provider’s office via electronic medical record system.
Explains whether provider participates with patient’s insurance and if not, describes options for payment.
Contact specialty partners and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis.
Be the navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns regarding their referrals.
Answer telephone promptly and in a polite and professional manner, following call center scripts.
Handles all incoming telephone calls from patients and answers general referral questions and inquires.
Receives, directs, and relays telephone and fax information.
Responsible for inputting very detailed information on the patients using a variety of computer screens.
Secures patient information and maintains patient confidence by completing and safeguarding medical records, completing diagnostic and procedure coding and keeping patients information confidential.
Follows up with patients regarding pending referral/authorization.
Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
Other duties as assigned.