Healthcare Referral Specialist

4 days ago

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

At American Family Care Ladera Ranch, we are seeking a highly skilled and detail-oriented Referral Coordinator to join our team. As a Referral Coordinator, you will play a critical role in ensuring the smooth operation of our referral process, working closely with healthcare providers, patients, and insurance companies to coordinate specialist visits and manage health-related information.

Key Responsibilities:
  • Standardize and maintain accurate and up-to-date referral policies and workflows.
  • Prioritize and track referrals based on urgency, ensuring timely resolution.
  • 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 medical information as necessary.
  • Review referral details and expectations with ordering providers and patients, requesting new referrals when applicable.
  • Develop and implement systems as required by EMR functionality and regulatory agencies.
  • Identify and utilize community resources, establishing relationships with servicing providers and personnel.
  • Serve as a point of contact for patients and specialists, addressing questions and concerns, and assisting with problem-solving.
Requirements:
  • Experience with referrals in healthcare preferred.
  • Experience with Electronic Health Records required.
  • Proficient knowledge of insurance policies, CPT, and ICD-10.
  • Computer literacy and proficiency in MS Office.
  • Excellent critical thinking and decision-making skills.
  • Strong customer service skills, professional attitude, clerical expertise, IT competence, and strong organizational skills.

We offer a dynamic work environment, opportunities for growth and development, and a competitive compensation package. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.

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