Referral Coordinator

CENTERPLACE HEALTH INC•North Port, FL

6d•Onsite

About The Position

The Referral Coordinator coordinates specialty care, outside scans, and x-rays for patients who need external consultation at the request of a primary care physician. The role researches referral requests promptly, verifies medical necessity, documents requests thoroughly to obtain prior authorization, prioritizes urgent referrals, and ensures referrals are followed through in a timely manner. The position also supports clerical and patient registration duties as needed.

Requirements

High school diploma or GED equivalent.
Some knowledge of or experience working with third-party vendors to complete referrals and authorizations, such as Availity, Medicare, or Medicaid websites.
Good oral and written communication skills.
Ability to interact effectively with physicians, patients, and other staff members.
Effective use of an electronic health record.
Basic typing skills.
Knowledge of proper, safe, and efficient use of current office equipment and software.
Knowledge and ability to use Office 365 programs, including Outlook, Word, and Excel.
Background check required.

Nice To Haves

One year of experience working in a medical office preferred.
Bilingual preferred.

Responsibilities

Review provider referrals in the EHR, verify procedures for accuracy, and contact providers for additional information when needed.
Contact insurance companies to verify patient coverage and obtain authorization; provide requested patient notes to insurers.
Send or fax referrals and patient notes to specialty offices, radiology centers, and insurance companies.
Coordinate peer-to-peer reviews between providers and insurance medical representatives when necessary.
Record procedure authorization numbers in medical records and communicate authorization documentation to referral facilities.
Provide patients with directions to referral locations when needed.
Update providers about urgent referral issues and discuss problems affecting referrals, such as lack of insurance or transportation barriers.
Accurately enter documentation into the EHR and ensure necessary referral information is available before visits.
Perform clerical duties as directed, including scheduling appointments, taking phone messages, scanning records, and patient registration.
Work in the referral workflow bucket and manage order entry, workflows, and work queues.
Complete required training, attend assigned meetings, protect patient confidentiality, arrange translation as needed, and respond appropriately to emergencies or threatening situations.
Perform other duties as assigned.