Healthcare Referral Specialist

4 days ago

Mission Viejo, California, United States American Family Care Ladera Ranch Full time
Job Title: Referral Coordinator

Join American Family Care Ladera Ranch as a Referral Coordinator and play a vital role in ensuring seamless healthcare referrals for our patients.

About the Role:

The Referral Coordinator is responsible for coordinating and managing referrals for patients, working closely with healthcare providers, specialists, and insurance companies to ensure timely and accurate referrals.

Key Responsibilities:
  • Standardize and maintain accurate referral policies and workflows.
  • Prioritize and track referrals based on urgency and address them in a timely manner.
  • Participate in the selection, orientation, and training of referral personnel.
  • Ensure complete demographic, insurance, and clinical information is sent to referred specialists.
  • Contact insurance companies to verify prior approval requirements and present necessary medical information.
  • Review referral details and expectations with ordering providers and patients.
  • Develop and implement systems as required by EMR functionality and regulatory agencies.
  • Identify and utilize community resources, establish relationships with servicing providers, and serve as a point of contact for patients and specialists.
Requirements:
  • Experience with referrals in healthcare preferred.
  • Experience with Electronic Health Records required.
  • Proficient knowledge of insurance policies, CPT, and ICD-10.
  • Computer literate and proficient in MS Office.
  • Excellent critical thinking and decision-making skills.
  • Strong customer service skills, professional attitude, clerical expertise, IT competence, and strong organizational skills.
Work Environment:

Monday to Friday, with a focus on providing exceptional patient care and ensuring seamless referrals.

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