Referral Coordinator

CLAREMEDICA HEALTH PARTNERS LLC•Miami, FL

1d•Onsite

About The Position

The Referral Coordinator works with patients to arrange and schedule referral appointments. Depending on the office, responsibilities may include providing patients with referrals to other care providers, managing incoming referrals, or both. The coordinator schedules appointments, sends reminders, and explains referral appointment details to patients. The role also supports referral authorization, documentation, patient navigation, and coordination with specialists, insurers, and other service providers. This position has no supervisory responsibilities. The work is performed in general office conditions, with a usually moderate noise level. Local travel between care centers may be required for coverage; job hazards are described as minimal.

Requirements

High school diploma, GED, or equivalent experience.
Educated on and compliant with HIPAA regulations, with strict confidentiality of client information.
Exceptional oral and written communication, time management, and organizational skills.
Ability to communicate professionally and courteously with employees, patients, and others.
Problem-solving mindset focused on patient needs and team goals.
Knowledge of medical products, terminology, services, standards, policies, and procedures.
Ability to remain calm in busy or stressful situations.
Strong listening skills.
Proficiency with Microsoft Office Suite, including Word, PowerPoint, Outlook, and Excel, and other word-processing, spreadsheet, database, email, and presentation software.
Ability to type at least 40 words per minute.
Basic phone and computer operation skills.
Ability to work independently within the role and collaboratively with team members.
Ability to organize and complete work in a timely manner.
Attention to detail to ensure accuracy of reports and data.
Ability to problem-solve, multitask, and follow instructions.
Ability to read, write, and communicate effectively in English.

Nice To Haves

At least one year of experience processing referrals, as a medical assistant, or in other clinical or front-desk work is preferred.
Bilingual ability is a plus.
HIPAA and AHCA experience preferred.
Healthcare experience preferred.
EMR system experience preferred.

Responsibilities

Schedule, coordinate, and resolve issues with referral appointments to outside specialists after receiving referral orders from designated Claremedica providers.
Maintain current knowledge of health plan carrier requirements for referral authorizations and approvals.
Provide attentive customer service in person and by phone.
Schedule initial and follow-up appointments with specialists and imaging facilities.
Track referrals and maintain appropriate documentation to support team awareness and patient safety.
Assemble information about patients’ clinical backgrounds and referral needs.
Provide specialists with appropriate clinical information in accordance with referral guidelines.
Contact review organizations and insurance companies to satisfy prior-approval requirements.
Present relevant medical information, such as history, diagnosis, and prognosis.
Provide financial services with medical information to support reimbursement, including requesting medical records as needed.
Review referral details and expectations with patients.
Help patients address health care, financial, and social barriers, including arranging interpreters, transportation services, or prescription assistance as appropriate.
Serve as a system navigator and point of contact for patients and families.
When appropriate, advocate with carriers to help secure timely approval of necessary patient supplies or services.
Identify and use cultural and community resources, and establish and maintain relationships with identified service providers.
Ensure referrals are addressed in a timely manner.
Remind patients of scheduled appointments by mail or phone.
Perform other administrative tasks as required by the Referral Management Supervisor.