Referral Coordinator, Primary Care Outer Loop, 8a-4:30p

The Referral Coordinator works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits and diagnostic imaging. Responsibilities include: processing referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement; scheduling; and, notifying patients of upcoming appointments.

• Gathers, verifies and processes referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers

• Communicates detailed information and answers patients’ questions regarding their health care plan; provide answers to billing and insurance clarification questions

• Sets up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.

• Coordinates flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient

• Enters referrals, documents communication and action into the system, as appropriate

• Notifies physician(s) and patient when referral is denied, or if additional information is needed

• Develops and maintains database of referral physician offices preferred by each physician within the clinic

• Assists Practice Manager with complaint resolution and solutions related to patient referral

Shift Length (in hours): 8 hours

# Shifts/Week: 5

Overtime Required: ☐ Infrequently     ☐ Sometimes    ☐ Often     ☐ n/a (exempt position)

• Promptly and professionally answers telephones calls

• Fulfills clerical responsibilities as assigned

• Maintains compliance with all company policies, procedures and standards of conduct

• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times

• Performs other duties as assigned

Education:

• High school diploma or equivalent (required)

Experience:

• Minimum one (1) year of working in a medical facility with knowledge of health care field and medical office protocols/procedures (preferred)