Referral Coordinator

This position is responsible for coordinating and processing referral requests, medical insurance verification and/or durable medical equipment for all Providers practicing within Family Christian Health Center. In addition to assisting in all aspects of patient care by acting as liaison for the health care team as it relates to quality and assurance.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Coordinate referrals electronically to specialists for all patients, including managed care and non-managed care as requested by Family Christian Health Center Provider’s.

1. Respond to patients' questions regarding referrals.

1. Monitor and investigate any delays in authorization/denial/redirection. Notify providers of denials, redirections, or delays.

1. Process and enters authorizations for "automatic authorization" referrals.

1. Monitor, answer and/or return messages within 24 hours.
2. Verify medical eligibility for specific insurance carriers as it pertains to the referral/authorization.

1. Maintain electronic log of referred patients to follow up referral services.
   

1. Accurately document all relevant information (including phone calls).

1. Provide monthly managed care/referral reports electronically as it pertains to quality and assurance.

1. Work to ensure that the Department is operating effectively and efficiently, consistent with Family Christian Health Center’s mission.

1. Attend various staff meetings as announced by Management (i.e. Quality, All-Staff, etc.).

1. Attend various referral update/training courses as available.

1. Ensure compliance with standards, laws and regulations as published by regulatory and accrediting organizations such as: BPHC, JCAHO, CLIA, OSHA, HIPAA, State and Federal Governments.

1. Participate in Care Team meetings as required.

• Associate degree or equivalent preferred
• Bilingual in English and Spanish preferred
• Preferred 2 years’ experience in a physician office with extensive patient registration, front desk and insurance experience.
• Preferred ICD-9, CPT coding experience and/or completion of a medical terminology course
• Preferred 1 years’ experience in healthcare electronic systems (i.e. EMR) pre
• Knowledge and ability to obtain authorizations and or pre-certifications from medical insurance plans
• Proven ability to interpret policies and procedures
• Advanced oral, written and interpersonal communication skills
• Must have the adaptability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure
• Advanced problem solving and organizational skills
• Proficient in Microsoft Office Suite (outlook, word, excel, power point)