Referral Coordination Specialist

3 weeks ago

Miami, Florida, United States Community Medical Group Full time
Job Title:

Referral Coordination Specialist

About the Role:

This role involves effective management of all incoming specialist referrals. As a Referral Coordination Specialist, you will coordinate and process patient referrals for specialty services.

Key Responsibilities:
  1. Coordinate and process patient referrals for specialty services with high accuracy.
  2. Verify registration data, demographic, and insurance information to ensure correctness and update it as necessary.
  3. Act as liaison between Community Medical Group and other healthcare providers, showcasing excellent customer service skills.
  4. Perform eligibility checks on members via telephone or electronically as needed.
  5. Follow procedures for authorization and processing of referral services, including obtaining approval from the medical director.
  6. Synchronize appointments, authorizations, and tests across different clinics, supporting physicians and patients.
  7. Set up appointments and transportation as required.
  8. Contact patients in a timely manner for scheduling purposes.
  9. Ensure follow-through with referrals by communicating with patients.
  10. Maintain strict confidentiality of health records, member information, and adhere to HIPAA guidelines.
  11. Coordinate pre-admission testing requirements with clinic personnel and patients.
  12. Complete administrative tasks related to referral activities efficiently.
  13. Enter referral, hospital, outpatient, and other patient specialty health service authorizations into the computer system according to CMG policies and procedures.
  14. Monitor referral reports not received and follow-up in a timely manner.
Requirements:
  • Education/Experience: High school diploma or equivalent.
  • Prior experience in a clinical setting is required.
  • Familiarity with MS Office programs.
  • Medical Assistant training or certification is preferred.
  • Knowledge of medical terminology, CPT, HCPCS, and ICD coding is preferred.
  • Electronic Health Records (EHR) knowledge is preferred.
Skills:
  • Demonstrate ability to use relevant information and individual judgment to determine compliance with laws, regulations, or standards.
  • Work independently and complete assignments within given parameters.
  • Use logic and reasoning to identify strengths and weaknesses of alternative solutions.
  • Develop constructive working relationships with others.
  • Understand written sentences and paragraphs in work-related documents.
  • Display strong initiative and problem-solving abilities.
  • Organize competing priorities effectively.
  • Show resourcefulness in problem solving.
  • Communicate effectively through strong verbal and written skills.
  • Be detail-oriented and organized.

The estimated salary range for this position is $45,000-$60,000 per year, depending on qualifications and location.

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