REFERRAL COORDINATOR I

Job Summary: 

 The Referral Coordinator is responsible for managing the referral process for patients within the healthcare facility. This includes coordinating with physicians, specialists, and other healthcare providers to ensure timely and accurate referrals. The Referral Coordinator plays a crucial role in facilitating communication between patients, healthcare providers, and insurance companies to optimize patient care and ensure seamless transitions between healthcare services.

Supervisory Responsibilities: N/A

Essential Duties / Responsibilities:

• Manage the referral process from start to finish, including receiving, processing, and tracking referrals.
• Coordinate with physicians and healthcare providers to obtain necessary documentation and information for referrals.
• Communicate referral status updates to patients, healthcare providers, and other involved parties.
• Verify insurance coverage and obtain pre-authorizations as needed for referrals.
• Schedule appointments for patients once authorization for services is confirmed.
• Register patients and create patient cases in the healthcare system, ensuring accurate documentation of referral details.
• Ensure that authorization is not submitted until contact is made with the patient and their willingness to proceed with the referral is confirmed.
• Maintain accurate and up-to-date records of referrals, patient information, and related communications.
• Assist patients in understanding the referral process, including insurance coverage and financial responsibilities.
• Collaborate with clinical staff and administrative personnel to resolve issues related to referrals and patient care.
• Monitor and report on referral metrics and performance indicators to identify areas for improvement.

Additional Responsibilities:

• Communicate with insurance companies for timely pre-authorizations.
• Assist with resolving billing inquiries related to referrals.
• Coordinate with patient care teams for seamless care transitions.
• Review referral processes regularly for efficiency improvements.
• Train staff in referral procedures and best practices.
• Maintain patient confidentiality and comply with HIPAA regulations.
• Participate in quality improvement efforts for referral processes.
• Perform other duties as assigned.

Required Skills / Abilities: 

• Strong organizational skills with attention to detail.
• Excellent communication and interpersonal skills.
• Ability to prioritize tasks and manage time effectively in a fast-paced environment.
• Proficiency in computer systems and electronic health records (EHR) software.
• Knowledge of medical terminology and healthcare processes.

Education and Experience: 

• High school diploma or equivalent required.
• Additional education or training in healthcare administration or related field preferred.
• Proven experience in a healthcare setting, preferably in referral coordination or related administrative roles.
• Experience with insurance verification and pre-authorization processes (preferred).

Physical Requirements:

• Involves sitting for extended periods of time.
• Home office setup: Maintain a dedicated workspace conducive to work and free from distractions.
• Reliable high-speed internet connection: Capable of supporting voice calls, data entry, and system usage without interruptions.
• Workspace security: Maintain a secure and confidential home office environment, adhering to company policies on data security and privacy.

*StrideCare is an Equal Opportunity Employer and is committed to diversity and inclusion in our workforce. We encourage applications from candidates of all backgrounds and experiences.