Referral Coordinator
1 month ago
We are seeking a highly organized and detail-oriented Referral Coordinator to join our team at The Center for Orthopedic and Research Excellence. The successful candidate will be responsible for verifying and updating patient registration information, obtaining benefit verification and necessary authorizations, and creating referrals to attach to pending visits.
Key Responsibilities- Verify and update patient registration information in the practice management system.
- Obtain benefit verification and necessary authorizations for all ambulatory visits, procedures, injections, and radiology services.
- Create referrals to attach to pending visits.
- Verify patient demographic information and insurance eligibility, including coordination of benefits.
- Update and confirm patient information as necessary to allow processing of claims to insurance plans.
- Complete chart prepping tasks daily to ensure a smooth check-in process for patients and the clinic.
- Research all information needed to complete the registration process, including obtaining information from providers, ancillary services staff, and patients.
- Fax referral forms to providers that do not require any records to be sent.
- Process 75-80 referrals daily for primary specialty office visits.
- Review and notify front office staff of outstanding patient balances.
- Maintain satisfactory productivity rates and ensure the timeliness of claims reimbursement while meeting work queue goals.
- Respond to in-house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow-up status.
- Identify and communicate trends and/or potential issues to the management team.
- Index referrals to patient accounts for existing patients.
- Create new patient accounts for non-established patients to index referrals.
- High school diploma/GED or equivalent working knowledge preferred.
- Minimum two to three years of experience in a healthcare environment in a referral, front desk, or billing role.
- Must be able to communicate effectively with physicians, patients, and the public and be capable of establishing good working relationships with both internal and external customers.
- Working knowledge of Centricity Practice Management and Centricity EMR a plus.
- Must have healthcare experience with managed care insurances, requesting referrals, authorizations for insurances, and verifying insurance benefits.
- In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.
- Working knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercial payers, and other funding sources.
- Knowledge of government provisions and billing guidelines, including Coordination of Benefits.
- Advanced computer knowledge, including Windows-based programs.
- A dynamic and supportive work environment.
- Opportunities for professional growth and development.
- A competitive salary and benefits package.
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