Referral Coordinator

Referral Coordinator

Requirements

• Knowledge of medical terminology, CPT, HCPCS and ICD coding desired
• Detail-oriented with the ability to multi-task. Must be open to cross-functionally training in referrals and back office duties
• Able to exercise proper phone etiquette with the ability to navigate proficiently through computer software systems
• Team-oriented with the ability to work extremely well with patients, colleagues, physicians and other personnel in a professional and courteous manner
• Exceptional organizational skills with the ability to effectively prioritize and timely complete tasks
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software
• Ability and willingness to travel locally within the market up to 10% of the time
• Spoken and written fluency in English; Bilingual a plus

Responsibilities

• Coordinates and processes patient referrals to completion with precision, detail and accuracy.
• Prioritizes HPP patients in Primary Care Physicians panel, stats, expedites and orders over 5 days.
• Orders have been approved (when needed).
• Schedules patient (Preferred Providers List of Specialist) and notifies them of appointment information, including, date, time, location, etc.
• Uses Web IVR to generate authorizations (Availity, Careplus, Healthhelp NIA and any other approved web IVR for authorization processing).
• Completes orders with proper documentation on where patient is scheduled and how patient was notified.
• Referrals have been sent to specialist office & confirmed receipt.
• Prepares and actively participates during physician/clinician daily huddles utilizing RITS Huddle Portal and huddle guide. Effectively communicates the physicians/clinicians needs or outstanding items regarding to patients.
• Enters all Inpatient and Outpatient elective procedures in HITS tool.
• Ensures patient’s external missed appointment are rescheduled and communicated to the physician/clinician.
• Participates in Super Huddle and provides updates on high priority patients referrals.
• Addresses referral based phone calls for Primary Care Physicians panel.
• Completes and addresses phone messages within 24 hours of call.
• Checks out patients based on their assigned physician/clinician. (Note: If assigned Care Coordinator is unavailable at the time of check out, a colleague shall assist patient. This process does not apply to Care Specialist)
• Retrieves consultation notes from the consult tracking tool.
• Follows up on all Home Health and DME orders to ensure patient receives services ordered.
• Provide extraordinary customer service to all internal and external customers (including patients and other ChenMed Medical team members) at all times. Utilization of patient messaging tools.
• Performs other related duties as assigned.

Preferred Qualifications

• Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred.
• Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred.
• Healthcare experience within the Medicare Advantage population preferred.
• Medical Assistant certification preferred.
• CPR for Healthcare Providers is preferred.