Referral Coordinator

Bronson Healthcare Group•Battle Creek, MI

11d•Onsite

About The Position

The Referral Coordinator coordinates all aspects of the referral process between patients, physicians, specialty offices, primary care offices, and insurance companies. The role manages referral activity and related electronic health record work queues according to office and provider preferences and patient needs. Employees providing direct patient care must demonstrate competencies specific to the population served. For Digestive Health, the role also processes and schedules Digestive Health procedures throughout the System, is cross-trained to assist with patient check-in and check-out, and covers the in-person scheduling desk on a rotational basis.

Requirements

High school diploma or GED and 1–2 years of related experience and/or training.
Knowledge of medical terminology, CPT, and ICD-9 coding.
Excellent computer skills, including Microsoft Office and Medic.
Excellent verbal and written communication skills.
Ability to maintain positive customer service.
Ability to establish effective working relationships with office staff and employees in a team environment.
Ability to maintain the highest level of confidentiality.
Effective prioritization skills and ability to manage time independently.
For Financial Clearance only: high school diploma or GED and 1–2 years of related experience and/or training.
For ProHealth only: Medical Assistant registry or certification, or an LPN license in Michigan, required within 90 days of hire.

Nice To Haves

Successful completion of a Medical Assistant or LPN program.
Current Medical Assistant registry or certification, or an LPN license in good standing and valid in Michigan.

Responsibilities

Coordinate referral activity between patients, physicians, specialty offices, primary care offices, and insurance companies.
Manage electronic health record referral and order work queues according to office/provider preferences and patient needs.
Coordinate and schedule referrals.
Obtain accurate billing and demographic information.
Ensure prior authorization for requested services in accordance with payer guidelines.
Communicate delays and denials to the ProHealth team and employer.
Process referrals using CPT and ICD-9 coding.
Participate in case management meetings.
Maintain patient confidentiality and excellent customer service, including problem-solving payor issues.
For Digestive Health, process and schedule procedures throughout the System.
For Digestive Health, assist with patient check-in and check-out and cover the in-person scheduling desk on a rotational basis.
Perform additional duties based on department needs.