Referral Coordinator

General Description :

The Referral Coordinator provides services related to medical referrals and orders to outside providers and organizations.  They also complete medication prior authorizations and works with the prior authorization team to support appeals and denials and is committed to the provision of patient centered / patient valued care.

Responsibilities

Specific Responsibilities of the Job :

• Coordinates the completion of medical referrals to outside providers, specialists, imaging centers, or other medical facilities by identifying providers and facilities that are in network with the patient’s insurance; sending referrals and appropriate medical information, communicating with receiving facility and patient to ensure appointments are scheduled; and following up with patient and facilities to obtain records.
• Coordinates referrals to Parkland and other facilities who provide services to uninsured patients.
• Maintains a database of providers who accept various insurance plans
• Communicates with patients regarding any barriers to completing outside appointments and works with staff, providers, financial team, case management or other resources to overcome barriers to care.
• Coordinates with providers, clinic, and finance staff to complete medication prior authorizations and appeals, as needed.
• Completes the care loop by continuously updating patients and providers with the status of medical referrals and / or medication prior authorizations.
• Serves as a patient advocate, focusing on patient needs, patient rights, confidentiality, and religious and cultural preferences. Assists in communicating these needs and preferences to the assigned clinical team.
• Maintains accurate and timely documentation of all activities performed.
• Other duties as assigned.

Required Skills

Required Knowledge, Skills, and Abilities :

Education and Experience :

High school diploma or GED

Previous experience with referral coordination and prior authorizations preferred.