Referral Coordinator

Referral Coordinator facilitates the delivery of comprehensive coordination and scheduling of patient care for outpatient services. Provides efficient informative service for incoming calls capturing patient medical histories and other health related information, scheduling of appointments and ensures appropriate referrals with facilitation of new patients into the facility. Initiates requests for authorization of patient services, verifies benefits, data enters/documents authorizations, and communicates status of authorizations to medical staff. Schedules referral appointments for tests, procedures, follow-up and communicates with referring physicians and/or physician offices. Demonstrates excellent customer service, written and oral communication skills. Provides customer support and resolves problems that may arise as of result of customer inquiries. MINIMUM QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school diploma or equivalent.

2. West Virginia state criminal background check required, and Federal, if applicable, for DHHR BMS regulated area.

EXPERIENCE:

1. Two (2) years’ experience in a healthcare outpatient setting.

PREFERRED QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Completion of Medical terminology class

2. Two years post high school education (health sciences, business, or related field)

EXPERIENCE:

1. One year experience in an oncology outpatient setting.

2. Ability to type 55 to 60 wpm

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Telephonically captures patient information for medical triage of all referrals demonstrating understanding and skill use of computer software and physician protocols. Coordinates referral process and scheduling of outpatient care.

2. Receives telephone calls from patient and their families and referring physicians/offices and triages calls appropriately. Responds to general inquires, regarding types of services available as well as provides information as requested.

3. Communicates consistently and accurately with a variety of contacts inside and outside the institution to obtain patient information, arrange tests and/or appointments relative to room allocation and physician availability.

4. Obtains and/or exchanges medical release of information forms as needed.

5. Coordinates and documents all referrals to and from the clinic including those received by telephone, fax, hard copy

6. Schedules and reschedules new patient appointments in accordance with scheduling guidelines, with the ability to prioritize according to patient needs and service; resolves scheduling conflicts quickly using critical thinking skills.

7. Enters complete and accurate information into EMR using comprehensive data elements in order to screen for appropriate scheduling of new patient appointment.

8. Mails patient information packet to the patient prior to all new patient visits and other visit types when applicable.

9. Uses specific guidelines to collect data and coordinates patient needs prior to first visit including pre-visit diagnostics and other information specific to diagnosis.

10. Opens, sorts, and distributes correspondence as well as slides/blocks with requisitions to appropriate faculty, staff and/or departments; appropriate correspondence is faxed to the referring physician office within 24-hours or one business day of referral.

11. Collaborates with appropriate service regarding incoming patient referrals to distinguish and determine type of referral ensuring to obtain patient’s necessary medical information and assigns to appropriate nurse/physician staff.

12. Contacts and collaborates with patient financial services to determine eligibility and benefits for requested services prior to scheduling of new patient appointment.

13. Calls outpatient 1-2 days prior to scheduled appointment verifying their commitment and rescheduling when appropriate

14. Verifies cancellations and makes changes to provider schedules as necessary; generates and distributes corrected schedules and information reports.

15. Calls all new patients that were a no call no show for first appointments scheduled and notifies referring physician office.

16. Ensures effective communication and collaboration among the health care team members, addresses inter- and intra- departmental issues. Maintains written verbal communication with referring institutions.

17. Maintains a record keeping system for appointment wait times for all new outpatient appointments.

18. Assists department in quality improvement activities and/or changes related to referral process.

19. Participates in identifying and resolving operational issues associated with growth of the clinic including handling of patient referrals, streamlining processes for documentation, and handling of referral communications. 

20. Collects data for quality improvement activities and assists in identifying discrepancies in referral process, developing, analyzing, and interpreting and identifying corrective action plans which include but are not limited to number of referrals, time from referral to new patient visit, no call no shows, and time to notifying referring physician.

21. Monitors and audits new patient visits for scheduling appointment within 7 days and no call no shows

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS AND ABILITIES:

1. Knowledge and understanding of medical terminology-oncology background

2. Excellent personal and communication skills.

3. Intermediate computer knowledge and ability to operate standard software programs.

4. Ability to communicate effectively and act as a liaison.

5.Proficient at the following electronic software systems but not limited to: EPIC, Word, Access, Power Point, Excel, Internet, Microsoft Outlook, HPF, Form Fast.

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