Referral Coordinator

CLAREMEDICA HEALTH PARTNERS LLC•Tamarac, FL

1d•Onsite

About The Position

At Claremedica, the team is dedicated to enhancing the lives of seniors in the communities they serve, striving for clinical excellence and unparalleled administrative support. The company fosters employee growth and wellness, providing resources, training, benefits, and competitive compensation. The primary duty of a Referral Coordinator is to work with patients to arrange and schedule referral appointments. This includes providing patients with referrals to other care providers, managing incoming patient referrals, or both, as well as setting appointments, sending reminders, and providing information about referral appointments.

Requirements

High school diploma, GED or equivalent experience required.
Educated on and compliant with HIPAA regulations; maintains strict confidentiality of client information.
Exceptional oral and written communication skills, time management skills and organizational skills.
Ability to communicate with employees, patients and other individuals in a professional and courteous manner.
Mindset focused on resolving problems for patients and achieving team goals.
Knowledge of medical products, terminology, services, standards, policies and procedures.
Ability to act calmly in busy or stressful situations.
Demonstrated strong listening skills.
Proficient skills in Microsoft Office Suite products including Word, PowerPoint, Outlook and Excel plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
Must be able to type at least 40 WPM.
Skilled in basic phone and computer operation.
Ability to work effectively within role independently and with other team members.
Ability to organize and complete work in a timely manner.
Detail-oriented to ensure accuracy of reports and data.
Proficiency with the ability to problem solve, multitask, and carry out instructions.
Ability to read, write and effectively communicate in English.

Nice To Haves

Minimum of 1 year of experience processing referrals, as an MA or other clinical/front desk experience preferred.
Bilingual is a plus.
HIPAA and AHCA experience preferred.
Healthcare experience preferred.
EMR system experience preferred.

Responsibilities

Schedules, solves problems, communicates, and coordinates referral appointments with outside specialists upon receipt of the Referral Order from designated Claremedica Provider.
Maintains a current working knowledge of all health plan carrier requirements for referral request authorizations and approval requirements.
Provide excellent service and attention to customers when face-to-face or through phone conversations.
Schedule initial and follow up appointments for specialist and imaging facilities.
Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
Assemble information concerning patient's clinical background and referral needs.
Per referral guidelines, provide appropriate clinical information to specialists.
Contact review organizations and insurance companies to ensure prior approval requirements are met.
Present necessary medical information such as history, diagnosis, and prognosis.
Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians, including requesting medical records as needed.
Review details and expectations about the referral with patients.
Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns.
May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
Identify and utilize cultural and community resources.
Establish and maintain relationships with identified service providers.
Ensure that referrals are addressed in a timely manner.
Remind patients of scheduled appointments via mail or phone.
Misc. administrative tasks as required by the Referral Management Supervisor.