Referral Coordinator

ChenMed-posted 3 months ago
Full-time • Entry Level
Memphis, TN
1,001-5,000 employees
Ambulatory Health Care Services
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The Care Coordinator is a highly visible customer service and patient-focused role. The incumbent in this role works directly with our patient population and their families, insurance representatives and outside vendors, physicians, clinicians and other medical personnel to ensure the referral process runs smoothly. He/She operates in a dynamic and professional environment to ensure the highest level of quality healthcare is delivered to our members.

  • Coordinates and processes patient referrals to completion with precision, detail and accuracy.
  • Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
  • Orders have been approved (when needed).
  • Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
  • Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
  • Completes orders with proper documentation on where patient is scheduled and how patient was notified.
  • Referrals have been sent to specialist office & confirmed receipt.
  • Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide.
  • Effectively communicates the physicians/clinicians needs or outstanding items regarding to patients.
  • Enters all Inpatient and Outpatient elective procedures in HITS tool.
  • Ensures patient's external missed appointment are rescheduled and communicated to the physician/clinician.
  • Participates in Super Huddle and provides updates on high priority patients referrals.
  • Addresses referral based phone calls for Primary Care Physicians panel.
  • Completes and addresses phone messages within 24 hours of call.
  • Checks out patients based on their assigned physician/clinician.
  • Retrieves consultation notes from the consult tracking tool.
  • Follows up on all Home Health and DME orders to ensure patient receives services ordered.
  • Provide extraordinary customer service to all internal and external customers at all times.
  • Performs other related duties as assigned.
  • High School diploma or equivalent required.
  • A minimum of 1 year of referral experience in a healthcare setting required.
  • Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
  • Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
  • Healthcare experience within the Medicare Advantage population preferred.
  • Medical Assistant certification preferred.
  • CPR for Healthcare Providers is preferred.
  • Knowledge of medical terminology, CPT, HCPCS and ICD coding desired.
  • An understanding of the company's patient population, including the complexities of Medicare programs.
  • Detail-oriented with the ability to multi-task.
  • Able to exercise proper phone etiquette.
  • Ability to navigate proficiently through computer software systems & use technology.
  • Spoken and written fluency in English; bilingual preferred.
  • Great compensation.
  • Comprehensive benefits.
  • Career development and advancement opportunities.
  • Great work-life balance.
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