Clinical Referral Specialist

Title: Referral Coordinator

Department: Clinical

Status: Non-Exempt

Position Classification/Category: Clinical

Level: N/A

Location: Assigned Clinic

Hourly Pay Range:

Reports To: Referral Supervisor

Direct Reports: N/A

Summary of Position

The Referral Coordinator is responsible for coordinating specialty care for patients in need of external consultation as requested by the primary care provider. The referral coordinator is responsible for closing the loop on all referrals s/he manages. S/he ensures closure of the referral process from initiation until the specialty report is received and forwarded to the referring provider for review.

Minimum Qualifications

Interacts in a respectful and professional manner with internal and external customers. Able to handle multiple and conflicting priorities simultaneously. Able to complete assigned work in allotted timeframe. Possesses strong critical thinking skills.

· Experience: 2 years of related work preferred

· Additional skills required: Knowledge of medical terminology. Proficient with Microsoft Office. Excellent verbal and written communication skills. Knowledge of local insurance carriers and plans.

• Additional skills preferred: Bilingual in English and Spanish.

Education: Associates degree in healthcare related field.

Certification(s)/Licensure: N/A

Physical Requirements:

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job.

· Repetitive movement of hands and fingers – typing and/or writing.

· Occasional standing, walking, stooping, kneeling or crouching.

· Reach with hands and arms.

· Talk and hear.

Key Responsibilities

1. Coordinate patient referrals to specialty providers throughout the entire referral process.

2. Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist.

3. Communicate with specialty office to schedule appointment.

4. Contact insurance companies to ensure prior approval requirements are met.

5. Organize and track ordered, scheduled and pending referrals.

6. Maintain appropriate documentation in electronic health record to ensure all patient and referral source communication is documented appropriately.

7. Review details and expectations about the referral with patients, including any financial obligations.

8. Act as a resource for patients or providers who have questions or problems relating to referrals. May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.

9. Establish and maintain relationships with identified service providers.

10. Ensure that referrals are addressed in a timely manner, prioritizing urgent items appropriately.

11. Work with assigned staff to ensure consult notes are received and directed to provider for review.

12. Participate in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and/or controlling program goals, objectives and/or services.

13. Support current incentive, regulatory, and certification requirements (such as Meaningful Use, PCMH and UDS) through documentation, participation in initiatives, and other activities as directed.

14. Perform other duties as assigned