Referral Coordinator

Bedford Stuyvesant Family Health Center•Brooklyn, NY

4d•Onsite

About The Position

The Referral Coordinator plays a critical role in ensuring patients receive necessary specialist care by managing the referral process efficiently. This position requires collaboration with healthcare providers, patients, and insurance companies to facilitate the timely and accurate coordination of services, including obtaining necessary prior authorizations.

Requirements

High school diploma or general education diploma (GED) or experience may replace education.
Two (2) years relevant work experience preferred.

Responsibilities

Process and expedite patient referrals to specialty offices and external providers.
Ensure complete and accurate registration, including verification of patient demographic information and current insurance coverage.
Maintain ongoing tracking and documentation of referrals, ensuring patients receive appointments in a timely manner and are cleared for their visits prior to their arrival.
Verify insurance benefits and eligibility, obtaining necessary pre-authorizations for services.
Act as a liaison between patients, providers, and insurance companies, proactively addressing any prior authorization or benefit-related issues.
Review details of the referral with patients, ensuring they understand the process, appointment details, and any required preparations.
Contact patients regarding any pending referrals or diagnostic testing, providing clear instructions and follow-up information.
Work closely with healthcare providers, clinical staff, and external specialists to gather necessary clinical information and facilitate patient care.
Coordinate appointments for hospital follow-ups, special medical procedures, and specialist visits.
Assist in scheduling preliminary testing when required and ensure completion before specialist visits.
Accurately document all referral information in the electronic medical record (EMR) system, ensuring up-to-date status tracking.
Maintain communication logs and relevant referral documentation, adhering to clinic policies and compliance standards.
Run periodic reports for nursing and provider staff to monitor patient compliance and for quality improvement initiatives.
Handle urgent and emergency referrals by prioritizing cases and coordinating with emergency services or on-call specialists.
Expedite insurance verification and documentation in emergency situations to avoid delays in care.
Follow up after emergency care to ensure appropriate follow-up appointments are scheduled.
Ensure all activities adhere to healthcare regulations, privacy laws, and institutional policies.
Participate in quality improvement initiatives and share best practices with colleagues to enhance overall process efficiency.
Provide training and support to staff as needed on referral processes and policies.