What are the responsibilities and job description for the Medical Referral Coordinator position at Confidential?
The Medical Referrals Coordinator is responsible for efficiently managing the referral process within the medical practice setting, ensuring timely and accurate documentation and verification of patient intake information and communication between patients, referring providers, and our specialists.
This is an in-office position, not remote.
Referral Coordinator Responsibilities:
Documentation:
Patient Demographics:
- Accurately input detailed patient demographic information into the practice management system (PMS), including full name, date of birth, gender, mailing address, contact details including email address and phone numbers, and emergency contact information.
Insurance Information:
- Enter accurate and detailed insurance plan information into the PMS, including policy numbers, group numbers, and contact information for the insurance provider.
- Verify patient has current active insurance coverage and benefits related to the referral, ensuring all necessary pre-authorization and referral forms are completed.
Coordination of Benefits:
- Document the coordination of benefits for patients with multiple insurance plans, ensuring proper order of billing.
Referral Specifics:
- Document the reason for the referral, including relevant clinical details and supporting documentation such as test results and imaging studies.
Authorization and Pre-certification:
- Insurance Pre-authorization:
- Submit required documentation and forms to insurance companies for pre-authorization of specialist initial office visits.
- Track the status of authorization requests, promptly addressing any issues such as denials or requests for additional information.
- Communicate with the patient's referring physician’s office to ensure all necessary documentation is provided.
Patient Scheduling and Communication:
- Convey completion of patient referral onboarding process to receptionists so that patient appointment can be scheduled.
Qualifications:
- High school diploma or equivalent; associate or bachelor's degree preferred.
- Minimum 2 years of experience in a medical office setting, preferably in a referral coordination role.
- Strong knowledge of distinct types of insurance plans: Medicare, Medicare Advantage, Medicaid, Commercial HMO & PPO plans
- Strong knowledge of insurance claim centers, payer ID numbers and identifiers
- Strong knowledge of medical terminology, insurance processes, and healthcare regulations.
- Proficiency in medical office software and electronic health record (EHR) systems.
- Previous experience with AdvancedMD practice management system desired
- Excellent organizational, multitasking, and communication skills.
- Ability to work independently and as part of a team.
Job Type: Full-time
Pay: From $18.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Disability insurance
- Health insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
Salary : $18
