Referral Coordinator

Summary

The Referral Coordinator is responsible for the effective management of all incoming specialist referrals.

Duties and Responsibilities

• Responsible for coordinating and processing of all patient referrals for specialty services.
• Utilizes a high degree of accuracy in obtaining and verifying that all registration data, demographic and insurance information is correct and up to date.
• Acts as liaison between Community Medical Group and other healthcare providers while exhibiting and utilizing a high level of customer services skills.
• Performs eligibility checks on members as necessary by telephone or electronically as appropriate.
• Follows procedures for proper authorization and processing of all referral services including obtaining approval from our medical director.
• Supports physicians and patients in synchronizing appointments, authorizations and tests taking place in different clinics.
• Sets up appointments and transportation as necessary.
• Contacts the patient on a timely basis for all scheduling requirements.
• Communicates with patients to ensure follow-through with referrals.
• Ensures strict confidentiality of all health records, member information and follows HIPAA guidelines.
• Coordinates pre-admission testing requirements with clinic personnel and patients.
• Completes all administrative functions related with referral activities in an efficient manner.
• Enters all referral, hospital, outpatient and other patient specialty health service authorizations into the computer system following CMG policies and procedures.
• Responsible for monitoring all referral reports not received and follow-up in a timely manner.
• Performs duties in honest and ethical manner.
• Perform other duties as assigned.

Qualifications

Skills :