Patient Referral Specialist
1 week ago
The Referral Coordinator plays a crucial role in ensuring the smooth operation of patient referrals within the healthcare system. This position involves meticulous management of patient information and coordination with various healthcare providers.
Key Responsibilities
- Ensure accurate verification and updating of patient registration details in the practice management system.
- Obtain necessary authorizations and benefit verifications for all outpatient visits, procedures, and services.
- Utilize online verification systems to confirm insurance eligibility with precision.
- Generate and manage referrals for pending patient visits.
- Verify and update patient demographic and insurance information to facilitate claims processing.
- Prepare charts daily to enhance the patient check-in experience.
- Conduct thorough research to gather necessary information for patient registration.
- Efficiently fax referral forms to providers as needed, managing a high volume of referrals daily.
- Notify front office staff regarding outstanding patient balances.
- Maintain productivity standards and ensure timely claims reimbursement.
- Address inquiries from providers and support staff regarding patient referrals and care coordination.
- Identify and report trends or potential issues to management.
- Index referrals accurately to patient accounts and create new accounts for non-established patients.
Qualifications
- High school diploma or equivalent preferred.
Experience
- Two to three years of experience in a healthcare setting, particularly in referral management or front desk roles.
- Effective communication skills with the ability to build strong relationships with patients and healthcare professionals.
- Familiarity with Centricity Practice Management and Centricity EMR is advantageous.
Requirements
- Experience with managed care insurances, including the referral and authorization processes.
- Comprehensive understanding of insurance plan requirements for Medicaid and commercial plans.
Knowledge and Skills
- Proficient in eligibility verification and prior authorization processes.
- Knowledge of billing guidelines and government provisions.
- Advanced computer skills, including proficiency in Windows-based applications.
- Ability to manage challenging situations with professionalism and maintain a positive demeanor.
- Strong organizational skills and attention to detail.
Work Environment
- Standard office environment with typical physical and mental demands.
- Requires sitting and standing, along with some manual dexterity for computer use.
Organizational Commitment
- Adherence to the mission, vision, and values of the organization is essential.
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