Referral Coordinator

EYE SPECIALISTS OF MID FLORIDA PA•Winter Haven, FL

4d•Onsite

About The Position

The Referral Coordinator ensures that authorizations and referrals are obtained before patients arrive for appointments and processes authorizations and referrals for patients seeking care from other specialist providers. The role involves reviewing upcoming appointments, checking authorization and referral status, submitting requests, maintaining records, communicating with providers, and updating patient information in practice management software. The coordinator may also travel to satellite locations as needed and must hold a valid Florida driver’s license. Overtime may be required. Additional duties may be assigned.

Requirements

High school diploma or GED required.
One year of experience in an ophthalmic setting required.
Proficient computer skills.
Ability to problem solve and attention to detail.
Understanding of Medicare, Medicaid, and other commercial insurance.
Knowledge of Medicare, Medicaid, HMO, and commercial insurance plans and eligibility requirements.
Familiarity with ICD-9/10 and CPT coding for ophthalmology.
Excellent communication skills, proper grammar, and writing capability.
Team-oriented, self-directed, and highly motivated; able to multitask in a fast-paced environment and handle multiple projects accurately and efficiently.
Exceptional interpersonal skills and a caring, patient, and friendly attitude.
Familiarity with paper and electronic forms associated with patient medical records.
Understanding of ophthalmic terminology and spelling, and general knowledge of ophthalmic diseases.
Valid Florida driver’s license.
Ability to travel to satellite locations as needed.
Ability to meet the stated physical demands, including walking, prolonged sitting, reaching, talking, hearing, stooping, crouching, bending, and lifting up to 25 pounds at times.
Ability to communicate clearly and professionally in person and over the phone, with adequate hearing for in-person and telephone duties.

Nice To Haves

Bachelor’s or associate degree preferred.
Experience in ophthalmic insurance verification preferred.

Responsibilities

Retrieve appointment lists by running appropriate reports five to seven days before visits and review each patient account.
Determine whether a referral or authorization is already on file or whether a new request is needed.
Create referral or authorization requests using the CPT procedure code fax form and send them with appropriate patient chart notes to the primary care physician for approval.
Maintain a log of requests sent to primary care physicians and follow up on requests that have not been received.
Communicate pleasantly and promptly with primary care physicians and specialist providers regarding referral or authorization requests and troubleshooting.
Document authorization details in the patient’s alert section of the medical record.
Correct inaccurate demographic or insurance information.
Enter demographic, referral, authorization, and patient information into practice management software.
Obtain insurance referrals or authorizations for emergency walk-in patients.
Scan referrals or authorizations into patient demographics in practice management software.
Exhibit a professional demeanor and positive, enthusiastic attitude when representing the practice.
Attend in-services and webinar training seminars as directed by the Manager.
Set, review, and revise professional growth goals and objectives.
Provide input on improving customer service, decreasing costs, and increasing practice revenues.
Support the practice’s core values and mission by promoting quality customer service through teamwork.
Maintain flexibility, sensitivity, and respect in working relationships with team members.
Maintain confidentiality, follow HIPAA and OSHA guidelines, and comply with practice rules and regulations.
Maintain productivity standards defined by management and complete additional tasks under the pay-for-performance program.
Assume other assigned duties.
Travel to satellite locations as needed for work assignments.