Referral Coordinator
4 weeks ago
Job Summary:
The Referral Coordinator is a vital member of the American Family Care Anaheim team, responsible for ensuring seamless referral operations. This role involves establishing and standardizing systems and procedures for the distribution and use of health information throughout the organization.
Key Responsibilities:
- Ensures current referral policies and workflows are standardized, accurate, and up-to-date.
- Prioritizes and tracks referrals by their urgency and addresses them in a timely manner.
- Participates in the selection, orientation, and training of referral personnel.
- Ensures complete demographic, insurance information, and appropriate clinical information is sent to referred specialists.
- Contacts insurance companies to ensure prior approval requirements are met.
- Presents necessary medical information to insurance companies to prove medical necessity of services.
- Reviews details and expectations about the referral with both ordering providers and patients.
- Develops and implements systems as required by EMR functionality and/or regulatory agencies.
- Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.
- Point of contact for patients and specialists for any questions or rising concerns.
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 competitive salary and benefits package.
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