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 to ensure 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, including deductibles, co-pays, and required deposits.
• Contact self-pay patients to arrange payment plans or discuss charity care options; may assist with Medicaid applications and refer patients to the District Financial Counselor.
• Verify insurance eligibility using system resources, insurance websites, and telephone verification.
• Schedule or coordinate scheduling of procedures for multiple departments and communicate issues with ordering physician staff as needed.
• Provide support through participation in departmental projects and assignments.
• Perform other duties as assigned.

Qualification Requirements

Education and License

• High School Diploma or equivalent, required.

Certifications

• No certifications required.

Experience

• Minimum of one (1) year of 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 required.

Additional Qualifications

• Ability to work with office equipment including computers, printers, copiers, multi-line telephones, paging systems, and fax machines.
• Knowledge of pre-authorization procedures and reimbursement denial follow-up.
• Excellent clerical skills including computer proficiency, spelling, and grammar.
• Knowledge of medical terminology.
• Strong organizational and multi-tasking skills in a high-volume environment.
• Excellent interpersonal communication and public relations skills.
• Professional appearance, conduct, and grooming suitable for a business office environment.
• Ability to work under pressure while maintaining a friendly and professional image.
• Ability to maintain confidentiality regarding patients, personnel, and other sensitive information.
• High level of understanding of medical terminology and anatomy.
• Ability to type accurately at a minimum of 40 words per minute.

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 up to a maximum of 50 lbs.

Benefits

• Dental Insurance
• Employee Assistance Program
• Employee Discount
• Flexible Spending Account (FSA)
• Health Insurance
• Life Insurance
• Paid Time Off (PTO)
• Retirement Plan
• Vision Insurance