About the position
We are excited to announce an opening for a Referral Coordinator at our Sanford office. As a Referral Coordinator you will be responsible for keeping track of the patient's referrals and ensuring that patients are scheduled for their recommended non-PCP appointments, maintain a list of all preferred specialist and ancillary providers, obtain referral authorization if required by the health plan, schedule specialist appointments for patients, and communicate respectfully and effectively with patients regarding appointments.
Responsibilities
- Supports the clinical team with the verification of all referrals created by IMA providers.
- Obtains timely referral authorization required by the patient’s health plan, if applicable, and follows up daily on pending actions needed to complete a referral.
- Process routine, urgent, and STAT referrals in accordance with company protocol.
- Proactively scheduled patient appointments and confirmed with patients and physicians.
- Confirms and documents all steps of the referral process to include authorization, outgoing and incoming faxes, fax received confirmation, outreach, and scheduling.
- Include appropriate clinical documentation by fax, including the last office visit, pertinent tests, and specialist agreement forms, in accordance with company protocol.
- Maintains the current list of all preferred specialist and ancillary providers.
- Document all interactions of the referral process within the EMR.
- Utilize the prior authorization resource tools to determine authorization requirements.
- Attaches the digital copy of the insurance authorization approval to the patient's referral/chart.
- Process patient documents according to company protocol.
- Collaborates with the Referral Manager and Network Manager to help identify preferred network of specialists by health plan, identifying specialists to the Network Manager who perform above or below IMA expectations.
Requirements
- High school diploma or General Education Degree (GED)
- Minimum 1-3 years of Referral Coordination or related clinical experience
- Minimum of 1-3 years of Electronic Medical Record (EMR) Experience (eClinical Works - eCW Preferred)
- Knowledge of insurance plans, ICD-10, and CPT codes
- Understanding of medical terminology
- Knowledge of Managed Care Services.
- Effective Communication Skills (Written and Oral)
- Excellent interpersonal relationships and customer service skills
- Exceptional time management and organizational skills
- Ability to travel for training if applicable
- Bilingual in Spanish and English (Preferred)
Benefits
- A welcoming and inclusive work environment
- Opportunities for professional growth and development
- Competitive salary and benefits package
- Health, Dental, and Vision Insurance
- 401(K) Retirement Plan with Matching
- Voluntary Short & Long-Term Disability
- Employer-Paid Life Insurance
- Paid Time Off, Floating Holidays, and Paid Major Holidays
- Employee Assistance Program (EAP)
