Referral Coordinator

Essential Job Functions, Duties, and Responsibilities

  • Ensure complete and accurate registration, including patient demographics and current insurance eligibility and benefits.
  • Contact review organizations and insurance companies to ensure prior approval requirements are met.
  • Ensure that all referrals and prior authorizations are addressed in a timely manner.
  • Identifies, assembles and provides pertinent and current information concerning patient’s clinical condition as well as PMH and diagnosis to refer to specialist/facility.
  • Maintains completed documentation in regard to referral/authorization to promote team awareness and status of the referral/authorization at all times.
  • Acts as a liaison between hospitals, physicians, health plans, vendors, and patients, or other referral sources. Schedules peer to peer review when necessary.
  • Contacts and reviews the details and limitations of the referral with the patient once finalized.
  • Other duties as assigned.

The omission of certain position duties does not limit the assignment of additional responsibilities as assigned.

Experience: Recent experience working in a physician office. Demonstrated knowledge of medical terminology and familiarity with third party payer guidelines and requirements.

Skillset requirements

  • Medical terminology knowledge
  • Familiarity with third-party payer guidelines and requirements
  • Strong customer service focus
  • Effective verbal and written communication skills
  • Team oriented
  • Organized and able to prioritize responsibilities
  • Good judgment and problem-solving skills
  • Ability to follow through with delegated tasks and accountability

Education: High school graduate or equivalent.

Physical Requirements: The typical demands to successfully perform essential functions of the position:

  • Normal vision, hearing, and ability to effectively communicate orally and in writing.
  • Ability to lift/carry 1 – 10 lbs.
  • Sitting for long periods of time 2 – 4 hours
  • Standing / Walking short periods of time 10 – 15 minutes

Reasonable accommodations may be available for individuals with disabilities upon employee written request.

Job Type: Full-time

Experience:

  • relevant: 1 year (Preferred)
  • Referral Coordinator: 1 year (Preferred)

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