Referral Coordinator

Job Description

Job Description

We are seeking a Referral Coordinator. The Referral Coordinator plays a critical role in ensuring patients receive necessary specialist care by managing the referral process efficiently. This position requires collaboration with healthcare providers, patients, and insurance companies to facilitate the timely and accurate coordination of services, including obtaining necessary prior authorizations.

• Referral Management:
• Process and expedite patient referrals to specialty offices and external providers.
• Ensure complete and accurate registration, including verification of patient demographic information and current insurance coverage.
• Maintain ongoing tracking and documentation of referrals, ensuring patients receive appointments in a timely manner and are cleared for their visits prior to their arrival.
• Insurance Coordination:
• Verify insurance benefits and eligibility, obtaining necessary pre-authorizations for services.
• Act as a liaison between patients, providers, and insurance companies, proactively addressing any prior authorization or benefit-related issues.
• Patient Communication:
• Review details of the referral with patients, ensuring they understand the process, appointment details, and any required preparations.
• Contact patients regarding any pending referrals or diagnostic testing, providing clear instructions and follow-up information.
• Collaboration and Coordination:
• Work closely with healthcare providers, clinical staff, and external specialists to gather necessary clinical information and facilitate patient care.
• Coordinate appointments for hospital follow-ups, special medical procedures, and specialist visits.
• Assist in scheduling preliminary testing when required and ensure completion before specialist visits.
• Documentation and Record-Keeping:
• Accurately document all referral information in the electronic medical record (EMR) system, ensuring up-to-date status tracking.
• Maintain communication logs and relevant referral documentation, adhering to clinic policies and compliance standards.
• Run periodic reports for nursing and provider staff to monitor patient compliance and for quality improvement initiatives.
• Problem Solving and Emergency Referrals:
• Handle urgent and emergency referrals by prioritizing cases and coordinating with emergency services or on-call specialists.
• Expedite insurance verification and documentation in emergency situations to avoid delays in care.
• Follow up after emergency care to ensure appropriate follow-up appointments are scheduled.
• Compliance and Best Practices:
• Ensure all activities adhere to healthcare regulations, privacy laws, and institutional policies.
• Participate in quality improvement initiatives and share best practices with colleagues to enhance overall process efficiency.
• Provide training and support to staff as needed on referral processes and policies.

Education and Experience:

• High school diploma or general education diploma (GED) or experience may replace education.
• Two (2) years relevant work experience preferred.

Benefits Overview: We offer attractive compensation with comprehensive benefits including Profit Sharing Plan, Medical, 401(k), and Long-Term Disability, Transportation Plan, Generous Paid Vacations and Holidays.

The Bedford-Stuyvesant Family Health Center (BSFHC) is a Federally Qualified Health Center (FQHC) that serves all of the primary health care needs of families in the heart of North and Central Brooklyn. Our mission is to provide the most professional, courteous, and highest quality health care, with dignity, to those we serve, especially the underserved population, without regard for ability to pay.

Company Description

The Bedford-Stuyvesant Family Health Center (BSFHC) is a Federally Qualified Health Center (FQHC) that serves all of the primary health care needs of families in the heart of North and Central Brooklyn. Our mission is to provide the most professional, courteous, and highest quality health care, with dignity, to those we serve, especially the underserved population, without regard for ability to pay.