About The Position

The Referral Coordinator coordinates all aspects of the referral process, including referral activity in the office between the patient, physician, specialty office, primary care office, and insurance company. Employees providing direct patient care must demonstrate competencies specific to the population served.

Requirements

  • High school diploma or general education degree (GED) and 1-2 years related experience and/or training required
  • Knowledge of medical terminology, and CPT, ICD-9 coding
  • Must have excellent computer skills (i.e. Microsoft Office, Medic).
  • Must have excellent verbal and written communication skills.
  • Ability to maintain positive customer service.
  • Ability to establish effective working relations with office staff and employees in a team environment.
  • Must maintain the highest level of confidentiality.
  • Effective prioritization skills and ability to manage time independently.

Nice To Haves

  • Successful completion of a Medical Assistant or LPN program preferred
  • Current Medical Assistant Registry or Certification, or LPN license preferred (must be in good standing and valid in the state of Michigan).
  • For ProHealth ONLY - Medical Assistant Registry or Certification, or LPN license in the state of Michigan required within 90 days of hire.

Responsibilities

  • Maintain patient confidentiality.
  • Maintain excellent customer service, including problem-solving payor issues.
  • Manages electronic health record referral/order work queues according to office/provider preference and the needs of patients.
  • Coordinates and schedules referral activity.
  • Obtains accurate billing and demographic information.
  • Assures prior authorization for requested services under payer guidelines.
  • Communicates delays/denials to ProHealth team and employer.
  • Process referrals by CPT, ICD-9 coding.
  • Participates in case management meetings.
  • Additional duties based on department
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