Referral Coordinator (CC26134 - NIC)

CommuniCare Health Center Jobs • San Antonio, TX

10d

About The Position

The Referral Coordinator answers telephones, schedules appointments, and provides customer service. The role processes referrals for Adult Medicine, Pediatric, Medical Specialty, and Behavioral Health providers. It verifies insurance coverage and benefits and obtains treatment authorization as required by insurance plans and third-party payer guidelines. Referral, authorization, and communication information is documented in the Electronic Health Record (EHR).

Requirements

• High school graduate or equivalent.
• At least one year of customer service experience; healthcare setting preferred.
• Excellent oral and written communication and interpersonal skills.
• Proficiency using personal computers, including Microsoft Word, Excel, and Outlook.
• Ability to handle multiple tasks efficiently with minimal supervision.

Nice To Haves

• Medical referral experience.
• Experience with EMR/EHR systems and medical terminology.
• Experience with insurance verification and healthcare billing.
• Bilingual in English and Spanish.

Responsibilities

• Schedule patient appointments using established provider templates, keep patient demographic and insurance information in the EHR complete and current, and coordinate with providers and support staff to optimize templates and make schedule changes.
• Document and relay information to external providers as appropriate to facilitate patient care.
• Use appropriate telephone etiquette and provide prompt, courteous service; participate in new initiatives and process improvements, including suggesting improvements to call flow and communication.
• Follow privacy and protected health information policies and report potential privacy breaches, HIPAA violations, or suspicious activity involving patient health records.
• Process referrals according to the date ordered and level of urgency, track them through completion, prevent backlogs, and maintain communication among staff, providers, and patients.
• Coordinate appointment scheduling among patients, primary care providers, and specialty providers, and notify a provider or supervisor about unusual delays, insurance issues, or other barriers to timely referral completion.
• Notify patients when referral processing is incomplete, explain the reason, provide feedback through the messaging system or by telephone, and give additional instructions as needed.
• Provide internal and external customer service by telephone, messaging system, and fax to assist patients with healthcare needs.
• Perform other related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED