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Referral Coordinator

1 month ago

Beverly Hills, California, United States ThreePDS Inc. Full time
Job Summary:

The Referral Coordinator is responsible for processing new patient referrals through our internal Central Registration System (CRS), ensuring accuracy of patient personal and insurance information. This role requires strong time management skills and the ability to complete assigned job duties with applicable supervisory direction.

Key Responsibilities:

Processes new patient referrals through CRS, ensuring accuracy of patient personal and insurance information.
Completes insurance benefit verifications via phone or online verification tools to confirm patient benefits, specific to the referred clinic, to determine acceptance to the clinic.
Works with clinic staff to ensure proper documentation for patient verifications is obtained.
Acts as first point of contact for patient's benefit or network status questions, escalating difficult conversations as necessary.
Ensures completeness and accuracy of patient accounts in billing system, QMS.
Resolves billing rejections related to patient demographic information, including working with the patient and/or payer for resolution if necessary.
Educates patients on financial responsibility while travelling internationally and drafts corresponding agreements for signature.
Initiates requests for authorization as needed based on insurance requirements and clinic network status.
Completes and maintains region and/or clinic specific reports.
Ensures compliance with CMS coordination of benefits rules.
Ensures confidentiality of all data, including patient, employee and operational data.
Adapts and is flexible when change arises, alternating between tasks as needed.
Stays current with department changes and updates and willingly learns new skills.
Handles patient information with discretion and sensitivity and maintains HIPAA compliance.
Understands and complies with Medicare rules and regulations, as well as applicable federal, state, agency, region and clinic rules and regulations.

Requirements:

Bachelor's degree- REQUIRED
2 years of experience in similar administrative setting (referral coordinator/benefits coordinator/admissions coordinator)- REQUIRED

About ThreePDS Inc.:

We offer competitive salaries and annual raises above the industry standard. We recognize your most recent dialysis experience in calculating your paid time off accrual, making your transition to our team easy without affecting valuable time off. We provide quality patient care to patients suffering from End Stage Renal Disease (ESRD) and continue to expand our network of dialysis centers to improve more lives every year.