Referral Coordinator - Full-time

Description

Referrals Coordinator

Summary: The Referral Coordinator provides support to the clinic providers and back office nurses. The Referral Coordinator makes referrals and appointments on a daily basis with the providers’ and nurses’ consultation. The Referral Coordinator works closely with the client, provider, nurse, and the insurance companies. The Referral Coordinator is responsible for maintaining high standards of care, maintaining a positive, caring, professional attitude. Works well with all staff members and is an important part of the Northeastern Rural Health Care team. The Referral Coordinator reports to the Referrals Supervisor.

Reports to: Referrals Supervisor

Duties and Responsibilities:

• Check patient insurance and demographics
• Assign a specialty care facility/provider, based on patient’s diagnosis
• Obtain authorization from the patient’s insurance for diagnostic imaging.
• Collecting and attaching all medical files relating to the patient’s diagnosis, which may include an Intake and/or Authorization Form for certain facilities.
• Send Referrals to the rendering
• Send the letter to the patient with the facility and/or provider information to inquire about referral.
• Document status of referral in the Notes section.
• Perform 14 and 21 day follow-up on all processed referrals
• Performs other duties as assigned.

Qualifications

Required Skills/Abilities:

High school graduate or GED. One or more years of medical office experience and knowledge of medical terminology. Experience working with managed care/HMO/PPO insurances. Able to work with various insurance companies. Understand the concept of managed care and the referral system. Must have excellent telephone and customer service skills, with the ability to maintain strict patient confidentiality. Must have good English, grammar, spelling, and basic math skills, computer literate, and word processing skills. Must be flexible, work both independently and as a team, and sit for long periods. Ability to work quickly and efficiently with minimal supervision.

Physical Requirements:

Frequent: sitting, standing, walking, working on computer 8-10 hours daily, lift/carry objects up to 24lbs, repetitive motion of hands & wrists, close eye work, color differentiation, exposure to infectious disease, exposure to emotional crisis of others, independent problem solving.

Constant: listening, speaking in person or on the phone, reading, writing, and working with public and staff.

HIPAA Exposure to PHI statement

“Employee provides services associated to the Northeastern Rural Health Clinics, its participating physicians and clinicians, which is a covered entity under the HIPAA rule. In the scope of performing functions, including but not limited to management, administrative, financial, legal and operational support services, I may have access to Protected Health Information (PHI), which is information, whether oral, written, electronic, visual, pictorial, physical, or any other form, that relates to an individual’s past, present or future physical or mental health status, condition, treatment, service, products purchased, or provision of health care and which reveals the identity of the individual, whose health care is the subject of the information, or where there is reasonable basis to believe such information could be utilized to reveal the identity of that individual”.