Referral Coordinator

ChenMed-posted 2 months ago
Full-time
AR
1,001-5,000 employees
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The Care Coordinator is a highly visible customer service and patient-focused role. The incumbent in this role works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel to ensure the referral process runs smoothly. He/She operates in a dynamic and professional environment to ensure the highest level of quality healthcare is delivered to our members.

  • Coordinates and processes patient referrals to completion with precision, detail and accuracy.
  • Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
  • Schedules patient appointments with preferred providers and notifies them of appointment information.
  • Uses Web IVR to generate authorizations for various insurance processing.
  • Completes orders with proper documentation on patient scheduling and notifications.
  • Sends referrals to specialist offices and confirms receipt.
  • Prepares and participates in physician/clinician daily huddles utilizing RITS Huddle Portal.
  • Effectively communicates physicians/clinicians needs regarding patients.
  • Enters all inpatient and outpatient elective procedures in HITS tool.
  • Ensures patients' external missed appointments are rescheduled and communicated.
  • Participates in Super Huddle and provides updates on high priority patient referrals.
  • Addresses referral-based phone calls for Primary Care Physicians panel.
  • Completes and addresses phone messages within 24 hours of call.
  • Checks out patients based on their assigned physician/clinician.
  • Retrieves consultation notes from the consult tracking tool.
  • Follows up on all Home Health and DME orders to ensure patient receives services.
  • Provides extraordinary customer service to all internal and external customers.
  • Utilizes patient messaging tools.
  • Performs other related duties as assigned.
  • High School diploma or equivalent required.
  • A minimum of 1 year of referral experience in a healthcare setting required.
  • 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.
  • Knowledge of medical terminology, CPT, HCPCS and ICD coding desired.
  • Detail-oriented with the ability to multi-task.
  • Open to cross-functionally training in referrals and back office duties.
  • Ability to exercise proper phone etiquette.
  • Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks.
  • Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook.
  • Spoken and written fluency in English; bilingual a plus.
  • Great compensation.
  • Comprehensive benefits.
  • Career development and advancement opportunities.
  • Great work-life balance.
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