Referral Coordinator (69267)

SANITAS OF TEXAS LLC•Surprise, AZ
•Hybrid

About The Position

The purpose of the Referral Coordinator position is to manage and facilitate the process of referring patients to other healthcare providers or services, ensuring that patients receive the appropriate care and services they need. This includes responsibilities such as following referral procedure guidelines, obtaining prior authorization as needed by health plans, processing referrals, and scheduling appointments to specialists for patients per provider requests. Referral Coordinators play a crucial role in maintaining the continuity of care within the healthcare system.

Requirements

  • High school diploma or equivalent
  • Minimum requirement of one year work experience with referrals, or related medical office experience
  • Proficient with Microsoft Office Suite or related software
  • Excellent verbal and written communication skills
  • Excellent customer service skills
  • Excellent organizational skills and attention to detail

Nice To Haves

  • Experience with EMR systems is preferred
  • Spanish Preferred
  • Creole Preferred

Responsibilities

  • Following referral procedure guidelines
  • Obtaining prior authorization as needed by health plans
  • Processing referrals
  • Scheduling appointments to specialists for patients per provider requests
  • Staying updated on healthcare regulations, insurance requirements
  • Providing training and education to other staff members as needed
  • Reviewing patient records and assessments
  • Assessing the specific requirements of the patient's condition
  • Collaborating with referring healthcare providers
  • Communicating with specialists or service providers
  • Verifying patient insurance coverage for the referral services
  • Obtaining necessary pre-authorization or precertification from insurance providers
  • Maintaining accurate and organized records of all referrals, including relevant details
  • Entering and updating referral data in the electronic system as appropriate
  • Documenting the reasons for the referral, dates, and specialist information
  • Explaining the referral process to patients, including reasons for the referral and what to expect
  • Resolving any challenges or obstacles that may arise during the referral process
  • Ensuring the referral process complies with healthcare regulations and privacy policies, such as HIPAA
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