Referral Coordinator

As a Referral Coordinator, you will assist patients by coordinating and obtaining required medical referrals and managing pre-collection activities for scheduled procedures. This position is responsible for proactively reviewing patient accounts to ensure required referrals are received and documented prior to services being rendered. When a required referral is missing, this role will communicate directly with primary care provider offices, referring providers, and patients to obtain the necessary documentation. This position will also be responsible for pre-collections related to patient financial responsibility for procedures, including provider professional fees for procedures performed at surgery centers and fees associated with in-office procedures.

Key Responsibilities

• Preemptively reviews upcoming patient appointments to identify referral requirements and ensure all required referrals are on file prior to services being rendered.
• Identifies missing, expired, or incomplete referrals and proactively contacts primary care provider offices to obtain the appropriate referral
• Communicates with patients when their involvement is necessary to obtain a required referral from their primary care provider or insurance plan
• Communicates necessary information to patients, staff, and therapists. 
• Verifies necessary information and records information in patient's medical record.
• Answers telephone, screen calls, clears voicemail, and returns patient calls in a timely manner.
• Answers questions regarding patient's upcoming appointments, referral status, and pre-collection requirements.
• Updates patient information in the patient electronic medical record.
• Registers patients in the patient electronic medical record as applicable.
• Confirms patient demographics and paperwork for accuracy, completions, and missing information.
• Ensures the proper clinical chart documentation and referral orders are present for all new patient appointments. 
• Relays prior authorization and/or referral needs to the authorization team and desk staff in accordance with patient insurance coverage prior to services being rendered.
• Maintains responsibility for following up on outstanding referral requirements and communicates unresolved issues to the appropriate team members to prevent delays or cancellations.
• Notifies all applicable staff as to status/completion of aboveprocesses.
• Courteously interacts with patients, family members, visitors, and members of the health care team; directs patient questions and/or complaints concernsto appropriate department; keeps patients informed of auth/referral status.
• Performs pre-collection activities for scheduled procedures in accordance with organizational policies and established workflows
• Manages pre-collections
• Reviews available patient financial responsibility information, including applicable copays, deductibles, and coinsurance amounts.
• Contacts patients prior to scheduled procedures to communicate estimated financial responsibility and to collect applicable payments
• Documents all pre-collection outreach, patient communication, payment attempts, and outcomes.
• Schedules patients for follow-up office visits or procedures.
• Assists in uploading medical records to the patient electronic record.
• Assists with proper routing of incoming faxes and documents.
• Maintains medical records in accordance with practice policies and procedures.
• All other duties as assigned.

Qualifications

• High school Diploma or GED
• Accurate typing skills, minimum 50 words a minute
• Knowledge of medical terminology
• Customer service skills
• Excellent verbal and written communication skills.
• working knowledge of computer programs
• 1 year experience of referrals and insurance verification 
• Strong organizational skills with the ability to manage follow-up on outstanding referrals and pre-collections