What are the responsibilities and job description for the Referral Coordinator position at Nooksack Indian Tribe?
Department: Health Department
Reports To: Clinic Manager
Job Status: Full Time
Grade: F
JOB SUMMARY:
The Referral Coordinator is responsible for ensuring that all patient referrals are processed efficiently and accurately. This role involves working closely with physicians, patients, insurance companies, and specialist offices to coordinate appointments, obtain necessary authorizations, and ensure continuity of care. The coordinator must be highly organized, possess excellent communication skills, and be knowledgeable in medical terminology and insurance procedures.
MAJOR TASKS AND RESPONSIBILITIES:
1. Process referrals from Providers in a timely manner, prioritizing the referrals according to defined levels of urgency.
2. Scheduling appointments as necessary, and coordinate with CHR as needed for patient transportation.
3. Inform patients about their referral status, scheduled appointments, and any preparatory instructions.
4. Answer patient inquiries regarding the referral process and provide clear guidance on next steps.
5. Track and follow up on all referrals to ensure timely appointments and continuity of care.
6. Ensure complete and accurate registration information, including patient demographic and current insurance.
7. Verify patient insurance coverage and determine if prior authorization is required for referrals or specialist visits.
8. Obtain prior authorizations from insurance companies when necessary.
9. Maintain accurate records of all referral activity, including referral requests, appointment scheduling, and authorizations.
10. Input patient information into Electronic Medical Records (EMR).
11. Insurance verification – maintain certification with Health Plan Finder (HPF).
12. Performs clerical and administrative functions to maintain patient data.
13. Assist patients with registering for, and use of, internal and/or external Personal Health Record (PHR) websites enabling the patients to view their health records.
14. Attend required staff meetings and in-service trainings as directed by supervisor.
15. Use effective problem-solving skills in the complex situations and resourcefulness.
16. Demonstrate ability to multitask with accuracy and deal effectively with unpredictable situations.
17. Maintain confidentiality of all patient information.
18. Provide general administrative and clerical support to clinic. Including answering phone calls, and emails.
19. Provides cross coverage as directed.
20. Other duties as assigned.
PREFERENCE:
Indian Preference Policy applies to this and all positions with the Nooksack Indian Tribe.
MINIMUM QUALIFICATIONS
The following qualifications are required for the applicant to have, in order to be considered for the position.
REQUIRED EDUCATION, EXPERIENCE AND TRAINING FOR POSITION:
High School Diploma or GED AND
Four (4) years healthcare experience OR
Associates Degree in relevant Healthcare field.
1 year(s) of customer service experience
REQUIRED SKILLS/KNOWLEDGE/ABILITIES POSITION:
A thorough understanding of scheduling, and coordinating referrals and appointments.
Ability to provide high quality patient centered customer service.
Ability to communicate effectively with Providers and insurance companies.
Ability to work independently in a fast-paced, patient focused environment with a professional demeanor. Functions well in stressful situations and prioritizes well with minimal direction.
Computer programs (e.g. EHR, Health Information Exchange/Personal Health Record, and Microsoft Office, Excel).
Knowledge of Medical Administrative Policies and Procedures (e.g., Health Insurance Portability and Accountability Act).
Ability to maintain concise and accurate confidential records of patients.
Ability to accurately interpret / document Medical terminology, abbreviations, and symbols. REQUIRED CONDITIONS OF EMPLOYMENT:
Must pass alcohol/drug test at time of hire and throughout employment.
Must pass pre-employment criminal background check, and Washington State Patrol, and periodically thereafter.
Obtain Tribal Assister certification within 6 months of hire.
REQUIRED LICENSES OR CERTIFICATIONS:
Must have and maintain, throughout employment, a valid Washington State driver’s license and meet the insurability requirements of the Tribe.
Current First-Aid and BLS-CPR (Basic Life Support) Certification required upon, or within 30 days of hire, and maintained throughout employment.
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):
Standard work week is 8:30-5:00, Monday through Friday.
Typical office setting with environmentally controlled conditions.
Occasional standing/walking while performing office duties; walking short distances throughout shift on tile, carpet or concrete.
While performing the duties of this job, the employee is regularly required to sit for long periods and frequently required to talk and listen.
May kneel or crouch occasionally to retrieve items from ground level.
Constant use of hands, fingers and arms to reach or grasp while using office equipment, and for other Administrative Duties.
Ability to Multi-Task: e.g., answer phones, and effectively interact with clients, patients and co-workers while giving and receiving instructions.
Ability to lift up to 20 pounds without assistance – occasionally.
Ability to read, write, and speak English.
DESIRED SKILLS/KNOWLEDGE/ABILITIES POSITION:
The following skills, knowledge or abilities are preferred / helpful for the applicant applying for this position.
Effective communication with doctors, nurses and other staff.
Effective Time-Management skills.
Ability to solve difficult problems with minimal supervision.
I have read and understand the position requirements as stated above. I further, understand that occasionally I may be instructed to perform duties that are not listed above but are relative to my positio
