About The Position

At NorthBay Health, this Referral Coordinator coordinates the referral process for patients and physicians utilizing access to care standards for all consults. Responsible to secure accurate patient demographics, authorizations and payer information in a timely manner to ensure patient care is not delayed. Verifies and documents eligibility and benefits for patient’s specific payers. Ensures appropriate documentation is in the patient’s Electronic Health Record (EHR). Schedules patient appointments and procedures as appropriate, and coordinates transfer of necessary records. Functions as the liaison to physicians and office staff, to expedite department/specialty access to care. Reviews and appropriately schedules patient appointments utilizing Department Specific appointment protocols.

Responsibilities

  • Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system.
  • Verifies insurance type and eligibility for care.
  • Prioritizes referrals based on clinical need as indicated by the ordering provider, and the Medical Services Request Form (MSR).
  • Completes, and documents, referral / scheduling process for all referrals for initial consult visits, as requested by the ordering provider (includes patient contacts, closure of referral, correspondence notification to PCP, as appropriate).
  • Observes provider schedules to ensure appointments are booked for correct appointment type and correct time allocation.
  • Schedules appointments for other specialty referrals and/or other services/procedures. Delivers appropriate information (office visits, labs, radiology reports, etc.) via fax, or in person to the specialty provider.
  • Schedules appointments and procedures for referrals for numerous Multi-faceted Specialty Care Offices as required.
  • Obtains additional information from referring provider when requested by consulting provider.
  • Assists in collection and reporting of statistical data, as requested.
  • Determines priorities for completion of support functions, tasks and projects.
  • Provides applicable basic education to patients to optimize the opportunity for customer satisfaction.
  • Provides assistance to Patient Services Representatives (PSR) and Medical Assistants as needed with referral duties.
  • Backs up PSR positions as needed.
  • Consistently demonstrates and promotes a sense of team within the immediate and extended work groups.
  • Establishes and maintains effective communication with physicians, co-workers and patients.
  • Participates in peer-based evaluations of other staff in specified areas as needed
  • Participates in educational programs, staff meetings and in-service meetings.
  • Performs other job-related duties and responsibilities, as assigned.
  • Maintains current competency files per Standards and annual requirements.
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