Referrals Coordinator Heart Care Clinic Full-Time Days

Trinity Health•Boise, ID

1d•Onsite

About The Position

The Referrals Coordinator serves as a specialist in coordinating incoming and outgoing specialty referrals for outpatient clinic patients. The role includes obtaining referral documentation and client information, verifying eligibility, benefits, and coverage, maintaining patient files, and entering accurate documentation in the electronic medical record (EMR). The coordinator manages referrals through assigned work queues, obtains required approvals, tracks referral status, and ensures the process is completed accurately and in accordance with federal regulations, network policies, and SAMG procedures. The coordinator works with providers, practice staff, patients, referral sources, specialist offices, review organizations, and insurance companies to resolve referral questions and problems, obtain missing records, communicate delays, and ensure timely follow-up. The role may include arranging diagnostic tests before new-patient appointments, reviewing referral details with patients, keeping primary care charts current with specialist consultation information, training new Referral Coordinators, and providing backup PSR coverage when needed. The clinic is located at 6140 W Curtisian Ave, Suite 300, Boise, Idaho 83704. The schedule is four 10-hour shifts, Monday through Thursday, on the day shift.

Requirements

High school diploma or equivalent.
At least 1 year of healthcare-related referral experience.
Ability to maintain HIPAA and other compliance requirements.
Ability to navigate EMR systems and accurately enter and track information.

Nice To Haves

Associate degree preferred.
Three years of healthcare-related referral experience preferred.

Responsibilities

Process and approve selected specialty referrals according to established network and SAMG policies and procedures.
Obtain referral request documentation and verify that required information has been received from referring provider offices.
Track referrals in the EMR through assigned work queues, document referral activity, close the loop, and resolve issues within appropriate timeframes.
Complete referral authorizations accurately and promptly, including verifying eligibility, benefits, coverage, and contractual appropriateness.
Compile relevant medical information and supporting documentation and send it to the appropriate recipient by fax or mail.
Communicate with referring provider offices to obtain missing documentation and updates about delays in contacting patients.
Act as a liaison among the practice, patients, referral sources, and health insurance companies to address complaints and resolve problems.
Monitor, resolve, and update the status of problem authorizations.
Gather information about patients’ clinical backgrounds and referral needs, and provide appropriate clinical information to specialists in accordance with insurance-plan referral guidelines.
Schedule diagnostic tests prescribed by specialist providers when needed before new-patient appointments.
Contact review organizations and insurance companies to meet prior-approval requirements and provide necessary medical information, including history, diagnosis, and prognosis.
Ensure referrals are addressed in a timely manner and record information needed to track referrals and support follow-up.
Keep patients’ primary care charts updated with information about specialist consultations related to their health.
Review referral details and expectations with patients and remind patients of scheduled appointments through the EMR, mail, or phone.
Train and orient new Referral Coordinators and provide training on current policies and procedures as needed.
Maintain HIPAA and other compliance requirements.
Enter, view, and independently formulate non-clinical information in the EMR using information from multiple sources; navigate complex EMR screens and ensure data is complete and accurate.
Bring errors or issues to the attention of the designated person.
Identify and use cultural and community resources and maintain relationships with identified service providers.
Perform other assigned duties, including backup PSR coverage when necessary.
Demonstrate the organization’s mission, vision, and values in behaviors, practices, and decisions.