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Referral Coordinator
4 weeks ago
At Mathiesen Memorial Health Clinic, we are seeking a highly skilled Referral Specialist to join our team. As a Referral Specialist, you will play a crucial role in coordinating, processing, and scheduling specialty referrals and prior authorizations for a variety of medical services/procedures for patients as requested by the medical provider.
Key Responsibilities:
- Schedule, problem-solve, communicate, and coordinate referral appointments with outside specialists.
- Track and enter all referral requests in the EHR daily.
- Coordinate with the Health Information Management staff to track the status of all provider reports on patients referred to hospitals, outside clinics, and Specialty Providers and follow up for reports/records not received on referred patients.
- Maintain an accurate record of external referral patient appointments that are kept or failed and update status in the EHR and/or Excel spreadsheet.
- Answer, respond, and document phone calls, requests, and questions from patients promptly.
- Utilize third-party payer/insurance portals; understand insurance and their expectations for authorization approvals.
- Ensure proper use of CPT and current ICD-10 codes to meet the requirements of third-party payers and specialty clinics to ensure minimal delay in securing referral appointments or pre-authorizations.
- Utilize electronic health record functions to document all pertinent information.
- May perform referral tracking process utilizing the EHR.
- Identify and utilize cultural and community resources.
- Establish and maintain relationships with identified service providers.
- Maintain TMAA hours and submit accordingly.
- Other duties as assigned.
Requirements:
- Minimum of a High School Diploma or equivalent.
- At least one year of relevant experience.
- Strong customer service skills.
- Effective verbal and written communication skills.
- Teamwork oriented.
- Organized and able to manage competing priorities, strong multi-tasking skills.
- Ability to work collaboratively with leadership, providers, and staff.
- Demonstrate professionalism in conduct, attire, and appearance.
Working Conditions:
Work is performed primarily in an office environment using standard office equipment with moderate background noise. It is a daytime shift only, Monday through Friday. Most of the day is spent viewing a computer monitor. The work environment characteristics described here represent those an employee encounters while performing the job's essential duties.
