Referral Coordinator

CLAREMEDICA HEALTH PARTNERS LLC•Tampa, FL

18d•Onsite

About The Position

The Referral Coordinator works with patients to arrange, schedule, and coordinate referral appointments with outside specialists and imaging facilities. The role may involve providing referrals to other care providers, managing incoming patient referrals, or both. The coordinator tracks and documents referrals, communicates appointment details and reminders, gathers and shares relevant clinical information, and helps patients navigate health care, financial, and social barriers. The position also supports authorization and approval processes, maintains relationships with service providers, and completes administrative tasks as needed. This role has no supervisory responsibilities. The work is performed under general office conditions, with local travel between care centers potentially required for coverage.

Requirements

High school diploma, GED, or equivalent experience.
At least 1 year of experience processing referrals, as a medical assistant, or in other clinical or front desk work is preferred.
Knowledge of and compliance with HIPAA regulations; ability to maintain strict confidentiality of client information.
Exceptional oral and written communication, time management, and organizational skills.
Ability to communicate professionally and courteously with employees, patients, and others.
Patient-focused problem-solving mindset and ability to achieve team goals.
Knowledge of medical products, terminology, services, standards, policies, and procedures.
Ability to remain calm in busy or stressful situations.
Strong listening skills.
Proficiency with Microsoft Office Suite, including Word, PowerPoint, Outlook, and Excel, and other word-processing, spreadsheet, database, email, and presentation software.
Ability to type at least 40 words per minute.
Basic phone and computer operation skills.
Ability to work effectively independently and with team members.
Ability to organize and complete work in a timely manner.
Attention to detail to ensure accuracy of reports and data.
Ability to problem-solve, multitask, and carry out instructions.
Ability to read, write, and communicate effectively in English.

Nice To Haves

Bilingual ability.
HIPAA and AHCA experience.
Healthcare experience.
EMR system experience.
Experience processing referrals, working as a medical assistant, or other clinical or front desk experience.

Responsibilities

Schedule, coordinate, and resolve issues related to referral appointments with outside specialists after receiving a referral order from a Claremedica provider.
Maintain current knowledge of health plan carrier requirements for referral authorizations and approvals.
Provide courteous service to customers in person and by phone.
Schedule initial and follow-up appointments with specialists and imaging facilities.
Track referrals and maintain appropriate documentation to support team awareness and patient safety.
Gather information about patients’ clinical backgrounds and referral needs, and provide appropriate clinical information to specialists in accordance with referral guidelines.
Contact review organizations and insurance companies to meet prior-approval requirements.
Present necessary medical information, including history, diagnosis, and prognosis.
Provide medical information to financial services to support reimbursement, including requesting medical records as needed.
Review referral details and expectations with patients.
Help patients address health care system issues and financial or social barriers, including arranging interpreters, transportation services, or prescription assistance as appropriate.
Serve as a system navigator and point of contact for patients and families, and help address their questions and concerns.
When needed, advocate with carriers to secure timely approval of necessary patient supplies or services.
Identify and use cultural and community resources, and establish and maintain relationships with service providers.
Ensure referrals are addressed in a timely manner.
Remind patients of scheduled appointments by mail or phone.
Complete other administrative tasks as required by the Referral Management Supervisor.