Referral Coordinator (63041)

UNION COMMUNITY CARE•North Lebanon Township, PA

5d•Onsite

About The Position

At Union Community Care, our purpose is to stand for whole health to help patients live their fullest lives. We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member’s unique culture, needs, and values. We believe in whole health, addressing disease and the causes of disease, and breaking down barriers to care. We connect with our communities because we are our communities. The Referral Coordinator is responsible for completing prior authorizations and arranging specialty care appointments for patients. They track and follow up on referral orders per Union policy and connect patients with resources to overcome barriers to completing referrals. Referral coordinators communicate between care teams and specialists, assist patients with accessing appointments, and complete referral documentation and forms.

Requirements

High School diploma or G.E.D.
Excellent telephone and customer service skills.
Healthcare experience required
Ability to keep track of frequently changing information and details of insurance companies, policies, practices and patients.
Work collaboratively with the care teams.
Ability to communicate in English fluently, including reading, speaking and writing
Medical terminology

Nice To Haves

prior referrals experience preferred

Responsibilities

Coordinates with patients, specialists’ offices and insurance companies to efficiently obtain prior authorizations for patients who need specialty care appointments and/or diagnostic tests that require prior authorization.
Coordinates with offices and patients to obtain appointments for patients and submits required documentation to authorize the visit with the payer.
Keeps up to date with all the insurance companies’ requirements, ensuring that the specific specialties and specialists needed by the patient are covered by the insurance company.
Understands and follows the protocols for referral and prioritization for each payer.
Develops a good working relationship with the various specialty offices to facilitate the referrals.
Maintains current lists of specialist offices, insurances with whom they participate, documentation required, and how to schedule patients with their office.
Prioritize work in the referrals bucket based on urgency.
Communicates regularly with the providers to keep them informed of the progress of the referral through the process.
Follows up and closes the referral loop per policy.
Performs all other work-related duties as assigned.