Referral Coordinator

Centrum HealthDoral, FL
Hybrid

About The Position

NeueHealth is a value-driven healthcare company focused on making healthcare accessible and affordable. We achieve this through owned clinics and partnerships, enabling providers to succeed in performance-based arrangements. Our mission is to transform healthcare and improve the care experience for all. The Referral Coordinator facilitates consistent information sharing across practices to promote care coordination and effective member co-management for behavioral and non-behavioral practitioners.

Requirements

  • High School Diploma
  • Minimum 2 years of experience in medical management.
  • Capacity to interpret health plan benefit decisions.

Nice To Haves

  • Certification as a Medical Assistant preferred.
  • High level of critical thinking and problem-solving skills
  • Strong work ethic and overall positive attitude
  • Effective communication skills including verbal and written.
  • Ability to manage time effectively, understand directions, and work independently in a fast-paced environment.
  • Demonstrated flexibility, organization, and self-motivation.
  • Highly adaptable to change.

Responsibilities

  • Prioritizes assigned patient cohorts to ensure specialty referral completion and ensures stat and expedited referrals are completed based on timeliness standards.
  • Schedules patients (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
  • Ensures missed specialty appointments are rescheduled and communicated to the physician/clinician.
  • Ensures specialist notifications of referral status.
  • Completes exchange of information by retrieving and ensuring upload of specialty consultation and follow up notes.
  • Completes documentation based on standardized documentation; to include location, notification of specialist, patient notification, status of appropriateness reviews.
  • Enters all Inpatient and Outpatient elective procedures in EMR and contacts specialists for post-procedure referral needs.
  • Follows up on all Home Health and DME orders to ensure patient receives services ordered.
  • Completes appropriateness review based on clinical protocols and appropriately refers to Nurse or Medical Director.
  • Addresses referral-based phone calls for Primary Care Physicians panel and completed phone messages timely.
  • Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned.
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