Referrals Coordinator

Referrals Coordinator

Job Summary

The Patient Access/Referrals Coordinator is responsible for handling activities related to orders, referrals, and authorizations. Assists with projects and assignments directly related to patient access and the revenue cycle. Works collaboratively as a team member for the smooth flow of clinic operations.

Essential Duties

• Process orders and referrals received; obtain, document, and verify referral, pre-authorization, or pre-certification information to ensure financial reimbursement for services rendered.
• Advise patients of estimated costs and patient liability (deductible, co-pay, deposits). Contact self-pay patients to arrange payment or discuss charity options; may assist with Medicaid application process and refer to the District Financial Counselor.
• Verify insurance benefits eligibility using system, web-based, and telephone resources.
• Schedule or coordinate scheduling of procedures for multiple departments; communicate issues with ordering physician staff as needed.
• Provide department support by participating in special projects and assignments as needed.
• Perform other duties as assigned.

Qualification Requirements

Education and License

• High School Diploma or equivalent (required).

Certifications

• None required.

Experience

• Minimum of one (1) year directly transferable experience in a medical office setting utilizing data entry skills, insurance websites, and various software applications.
• Experience utilizing ICD-10 and CPT coding (required).
• Experience working in a medical office or scheduling center.

Additional Qualifications

• Ability to work with office machines and equipment (computers, printers, copiers, multi-line phones, paging systems, fax machines).
• Knowledge of pre-authorization procedures and reimbursement denial follow up.
• Excellent clerical skills including computer knowledge, correct spelling, and grammar.
• Medical terminology.
• Strong organizational and multi-tasking skills in a high-volume environment.
• Excellent interpersonal communication and public relations skills.
• Appropriate manner, conduct, and grooming for a business office setting.
• Ability to work under pressure with continuous calls while projecting a friendly, professional image.
• Ability to maintain confidentiality regarding patients, personnel, and other sensitive matters.
• High level understanding of medical terminology and anatomy.
• Accurately type a minimum of 40 wpm.

Work Environment

Works indoors in an air-conditioned environment.

Physical Demands

Frequent use of computer and phone, and other standard office machines. Must be able to stand, sit, stoop, twist, kneel, reach, push, pull using proper body mechanics and move/lift varying amounts of weight to a maximum of 50 lbs.

Benefits

• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance