Referral Coordinator
1 week ago
We are seeking a highly skilled Referral Coordinator to join our team at Ocean State Job Lot. As a Referral Coordinator, you will play a critical role in guiding patients through the healthcare system by providing education, assisting with accessing community resources, developing relationships with service providers, and tracking interventions and outcomes.
Key Responsibilities- Process all subspecialty and diagnostic referrals and communicate with outside specialty care, diagnostic agencies, and IPA/health plans to initiate referral until appointment is obtained.
- Notify patients of appointment times, educate them regarding significance of specialty/diagnostic appointment, provide reminder calls, and assist patients with their appointments.
- Track status of referrals on an ongoing basis and maintain referral log including, at a minimum: specialty, date of referral, date of appointment, date patient notified, show/no-show status, date specialty consult note received by MLK CMG, and date consult note reviewed/signed by MLK CMG provider.
- Document and maintain accurate records for all client encounters including phone encounters and correspondence.
- Prepare and submit monthly reports of activities as requested.
- Ensure that referrals are addressed in a timely manner.
- Research and update outside referral sources on an ongoing basis.
- Serve as a liaison between patients and medical staff for both internal and external services.
- Review patient charts prior to releasing to requesting provider/department for needed forms and reviews prior to completion; replenishes forms as needed. Returns records to providers for completion when indicated.
- Ensure complete and accurate registration, including patient demographic and current insurance information.
- Contact review organizations and insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis and prognosis. Provides specific medical information to financial services to maximize reimbursement to the hospital and physicians.
- Reviews details and expectations about the referral with patients.
- Works aggressively with physicians and physician office staff to obtain necessary medical information relating to the referral.
- Meets or exceeds Referral Department productivity targets on a weekly basis.
- Demonstrates initiative, motivation, and resourcefulness in day to day operations.
- Attends any meetings as directed by management. Meetings may be held at other outside facilities.
- High School diploma or GED.
- At least (1) year experience with patient referrals.
- Proficient in Microsoft Office including Outlook, Word and Excel.
- Strong customer service focus with effective verbal and written communication skills.
- Minimum of (1) year experience with patient referral process.
- Knowledge of managed care plans and requirements.
- Knowledge of CPT and ICD codes.
- Knowledge of state and county programs including eligibility requirements.
Ocean State Job Lot is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment that values diversity, equity, and inclusion.
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