Referral Coordinator

UNION COMMUNITY CARE•Coatesville, PA

13d•Onsite

About The Position

The Referral Coordinator completes prior authorizations and arranges specialty care appointments for patients. The role tracks and follows up on referral orders according to Union Community Care policy, connects patients with resources to help overcome barriers to completing referrals, communicates between care teams and specialists, assists patients with accessing appointments, and completes referral documentation and forms. The position coordinates with patients, specialist offices, and insurance companies to obtain prior authorizations for specialty care appointments and diagnostic tests. It also coordinates appointments and submits required documentation to payers, maintains knowledge of insurer requirements and referral protocols, and develops working relationships with specialty offices. The Referral Coordinator maintains current information on specialist offices, participating insurers, documentation requirements, and scheduling procedures; prioritizes referrals by urgency; keeps providers informed of referral progress; and follows up to close the referral loop. The position also participates in mandatory all-staff meetings, team meetings, and trainings, and performs other work-related duties as assigned.

Requirements

High school diploma or G.E.D.
Excellent telephone and customer service skills.
Healthcare experience required.
Ability to track frequently changing information and details concerning insurance companies, policies, practices, and patients.
Ability to work collaboratively with care teams.
Fluent English communication skills, including reading, speaking, and writing.
Knowledge of medical terminology.

Nice To Haves

Prior referrals experience preferred.

Responsibilities

Coordinate with patients, specialist offices, and insurance companies to obtain prior authorizations for specialty care appointments and diagnostic tests.
Coordinate appointments with specialty offices and patients, and submit required documentation to authorize visits with payers.
Keep current on insurance company requirements and confirm that needed specialties and specialists are covered by a patient's insurance.
Follow payer-specific referral and prioritization protocols.
Develop working relationships with specialty offices to facilitate referrals.
Maintain current lists of specialist offices, participating insurers, required documentation, and appointment scheduling procedures.
Prioritize work in the referrals bucket based on urgency.
Communicate regularly with providers about referral progress.
Follow up on referrals and close the referral loop according to policy.
Participate in mandatory all-staff meetings, team meetings, and trainings.
Perform other work-related duties as assigned.