About The Position

Under the direction of the appropriate Manager, supervises and coordinates day to day referral activities, operations and personal issues of the assigned referral staff. Acts as a liaison with staff, departments/clinics and patients.

Requirements

  • 2 years - Experience working as a Referral Coordinator in an Ambulatory clinic - required
  • 2 years -Thorough knowledge of insurance- HMOs, Medicare, Medicaid, PPO, POS and third-party payors - required
  • 2 year - Thorough knowledge and understanding of HIPAA, Medical Necessity Software, Scheduling/Registration systems and insurance web portals. - required
  • High School Diploma - required

Responsibilities

  • Provides oversight of the daily referral operation for the department including participating in hiring, staffing, training, coaching and providing feedback.
  • Ensures compliance of regulatory and organizational policies and procedures and recommends changes in department policies and procedures as identified.
  • Assists with personnel and payroll functions, and provides daily support with Kronos to ensure time is effectively managed.
  • Works closely with the Manager in effective scheduling of staff and workflow to provide optimum coverage with available resources to meet department goals relating to production and quality.
  • Ensures appropriate budgetary standards are implemented and maintained for labor and supplies.
  • Supports the work of the manager by answering inquiries, providing information and resolving complaints from patients or other internal or external departments as it relates to referrals.
  • Reviews referrals and authorization requirements to assure compliance with health plans.
  • Monitors managed care referral process to ensure accurate and consistent process/results. Reviews pending referrals daily to ensure timely completion. Responsible for proficiently tracking and recording reports in the referral system.
  • Supports the objectives and goals of the referral team by functioning as a referral coordinator.
  • Provides a standard of excellence as it relates to customer services for patients, staff and other customers. Participates as an active care team member in the coordination of patient care.
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