Referral Coordinator-Clifton Park

Trinity Health•Troy, NY

3d•$19 - $26•Onsite

About The Position

The Referral Coordinator supports the care team by managing referrals from initiation through completion. The role tracks specialty and diagnostic referral orders, handles related communications, gathers and shares appropriate clinical information, explains referral details and preparation instructions to patients, and coordinates appointments with patients, physicians, specialists, and central scheduling. The coordinator prioritizes requests according to urgency and serves as the office point of contact and subject-matter resource for referral matters. The role also obtains and documents authorizations for referrals and diagnostic testing, keeps current on payer requirements, communicates insurance decisions, and follows up with physician offices, patients, and payers as needed. The coordinator confirms whether specialists are in-network and works with patients and the care team on alternatives when needed. The position is part-time, based at 855 Rt 146 in Clifton Park, New York, with Monday–Friday daytime office hours in four-hour shifts.

Requirements

High school diploma or equivalent required.
At least 5 years of experience in a medical office.
Effective written and verbal communication skills.
Knowledge of insurance payers and processes.
Attention to detail, organization, and effective time management.
Ability to work independently with little supervision.
Knowledge of ICD-10, CPT, and CPT II codes.
Sound judgment and ability to escalate issues appropriately.
Advanced knowledge of Microsoft Office, related computer programs, and general office machines.
Ability to communicate effectively with patients while providing exemplary customer service.

Nice To Haves

Bachelor of Arts degree preferred.

Responsibilities

Maintain and track referrals from beginning to end, including specialty and diagnostic referral orders.
Answer, respond to, and document calls, requests, and questions from patients, physicians, ancillary services, and specialty offices in a timely and accurate manner.
Assemble information about patients’ clinical backgrounds and referral needs, and provide specialists with documented clinical information according to referral guidelines.
Review referral details and expectations with patients.
Communicate preparation instructions to patients through documented orders or protocols.
Receive and review referral requests and prioritize orders based on urgency.
Schedule and coordinate referral appointments, troubleshoot issues, and communicate with patients, physicians, specialists, and central scheduling.
Collaborate with care team members, including physicians, mid-level providers, LPNs, and MAs.
Maintain patient confidentiality and comply with HIPAA guidelines.
Obtain and document authorizations for referrals and diagnostic testing in a timely manner.
Work with the Billing Analyst on denied claims related to missing prior authorization or referrals in the EMR system.
Maintain current knowledge of referral and payer prior-authorization requirements, eligibility guidelines, and documentation requirements.
Communicate insurance decisions to patients.
Conduct follow-up calls with physician offices, patients, and payers as needed to complete pre-certification.
Confirm that specialists are in-network; when they are not, contact patients to discuss alternatives and coordinate arrangements according to payer guidelines and with the care team.
Serve as the referral point of contact and subject-matter resource for assigned offices.