Referral Coordinator

• Scheduling appointments with patients, physicians, and other medical staff members and insurance portals. • Coordinating with insurance companies to verify eligibility, coverage criteria, and benefits. • Coordinated referrals and completed patient assessments • Coordinated and provided in-services for referral sources

Job Responsibilities & Duties:

• Scheduling appointments with patients, physicians, and other medical staff members and insurance portals.
• Coordinating with insurance companies to verify eligibility, coverage criteria, and benefits.
• Coordinated referrals and completed patient assessments
• Coordinated and provided in-services for referral sources
• Expediting patient referrals to specialty offices
• Completing referral requests as needed
• Faxing and sending medical records to our various departments for processing
• Monitored outside relationships with other facilities and other public relations activities

· Records timely in EHR per the corporation’s policy and procedure in a timely manner

· Obtains clinical information required to request prior authorizations

· Create patient charts in ECW and enter all information

· Generate specialty referrals for members as requested by primary care physicians

· Call to schedule all incoming referrals via fax inbox and physician portals

· Maintain accurate insurances and office information in physician portals

· Consult with other department regarding referral needs, insurance verification and eligibility

· Maintain timely responses to referral requests

These duties are not exclusive and with consideration of the job requirements and employee skills, this job description can be added to or taken away from the discretion of the employee’s immediate supervisor.

• Strong customer service background preferred.
• Education High School diploma.
• Minimum of two years’ experience of pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO’s, and PPO's required.

Dress Code:  Black scrubs and closed toe shoes are required for this position or business casual

• Educated on and compliant with HIPAA regulations; maintains strict confidentiality or client information.
• Ability to work effectively within role independently and with other team members.
• Ability to organize and complete work in a timely manner.
• Ability to understand medical/surgical terminology.
• Proficiency with Windows, Microsoft Office (Word, Excel, Outlook, PowerPoint, Internet Explorer).
• Ability to receive instructions.