Referral Coordinator| Referral Coordinators| Full Time| Days
Required skills
- Referral Coordinator
- referral requests
- clinic module
- referral/authorization numbers
- Referral training
- referral system training
- referral policies
- payer requirements
- Managed Care Matrix
- Processes referrals
Nice to have
- Diagnosis and Procedural coding
- Computer experience
Role summary
The Referral Coordinator is responsible for processing referral requests for all providers within the clinic module, ensuring necessary referral/authorization numbers are obtained. This role requires staying current on referral policies, procedures, and payer requirements. Key duties include processing referrals, obtaining authorizations, scheduling appointments within required timeframes, and maintaining network/payer compliance. The position also involves communicating with stakeholders, documenting information in systems, and providing excellent customer service to patients and staff. A High School Diploma or GED is required, along with 2 years of experience in customer service and third-party payer relations.
This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services.
Responsibilities
Successfully completes Referral training class and various referral system training classes. Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting. Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources.
Processes referrals for services requested by Providers within established guidelines.
Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes. Coordinates appointment date, time and location with patients.
Processes requests for additional referrals/authorizations when requested by providers.
Assures referrals are maintained within appropriate network or payer requirement.
Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure.
Documents required information into the appropriate systems.
Provides a standard of excellence as it relates to customer service for patients, staff members, and other customers
Qualifications
Experience Requirements:
2 years - Diagnosis and Procedural coding - preferred
2 years - Experience in the field or in a related area - required
2 years - Customer service - required
2 years - Third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field - required
Preferred Experience:
Computer experience - preferred
Education:
High School Diploma or GED equivalent - required
Certificate Medical Terminology - preferred
Travel
Up to 10%
UFJPI is an Equal Opportunity Employer and Drugfree Workplace
