Referral Coordinator

The Referral Coordinator provides oversight/management of the Referral Specialists to ensure the timely and accurate scheduling of specialty appointments as requested by Neighborhood Family Practice Clinicians and Providers. The Referral Coordinator provides administrative support to improve workflows, communication, adherence to Neighborhood Family Practice procedures, and ongoing auditing of documentation in the Electronic Medical Record.

Essential Duties and Responsibilities: The following description is a general representation of the essential duties and responsibilities of the position.

• Manage[KP1] Referral Specialists, including hiring, training, evaluating, onboarding, and providing guidance on best practices.
• Monitor workflows to ensure timely and accurate processing of referrals. Develop, implement, and evaluate workflow modifications on an ongoing basis. Collaborate with Quality Improvement and Population Health teams to drive improvement and change both within the department and at organizational level.
• Conduct monthly audits on referral processing, urgent referral follow-up, EPIC In-based management, and Quality Improvement/Population Health Activities. Ensure data and documentation is entered appropriately for compliance and data retrieval purposes. Analyze data to identify trends and make recommendations for improvement.
• Understand insurance company documentation requirements to improve referral and prior authorization approval. Ensure referral specialists provide detailed, accurate, complete, and timely information for referrals and authorizations to insurance companies and proactively remove barriers.
• Collaborate with referral specialists for research conducted based on inquiries and requests. Provide guidance on complex referrals, obtaining appointments, removing barriers to care, and gaining access to necessary resources for care. Assist referral specialists in resolution of complex issues.
• Oversee emergency room and discharge from hospital process to facilitate timely follow-up appointments with NFP providers.
• Consult with Community Health Workers regarding community resources to assist patients in managing healthcare needs, improve access to referral sources, and identify emerging trends.
• Other duties as assigned.

Education, Licensure, Experience:

• High School Diploma or equivalent required. Associate's degree or higher preferred.
• 3+ years' experience in healthcare or health-related discipline required.
• 2+ years of supervisory experience preferred.
• Certification/Licensure as Community Health Worker or similar preferred but not required.

Knowledge and Skills:

• Knowledgeable of medical terminology, medical billing practices, and insurance coverage.
• Highly organized with the ability to handle multiple priorities while remaining professional and calm.
• Computer proficiency in Microsoft Office Suite, EPIC EHR, and database management.
• Demonstrated ability to establish and maintain effective professional relationships with people of various cultural and ethnic backgrounds.
• Strong customer service and people skills including patients and empathy.
• Sound decision-making skills - able to maintain high levels of confidentiality while effectively troubleshooting problems and resolving to satisfaction.
• Fluency in language other than English relevant to patient population preferred.

Essential Physical Demands and Working Environment:

• Able to communicate effectively both verbally and in writing, including through the use of electronic communication devices.
• Able to sit, stand, bend, and stoop for extended periods of time.
• Occasional lifting of up to 25lbs
• Able to travel locally among Health Centers