Referral Coordinator Non-Clinical -Care Coordination

Provider Referral Coordinator

As a Provider Referral Coordinator, you will play a critical role in our healthcare team, dedicated to delivering the highest quality of patient support. This position is responsible for the seamless coordination of provider specialty referrals from start to finish, ensuring exceptional customer experience and meticulous stewardship. Your key responsibilities include providing friendly, rapid, and accurate patient support, completing patient registration documentation, scheduling appointments, and assisting with various departmental projects and clerical duties. Specifically, you will manage the entire provider specialty referral process, from the initial referral request to the final appointment, ensuring seamless transitions and timely follow-ups. You will also coordinate and schedule appointments for patients with various specialists, taking into consideration the urgency and nature of the referral, and ensure patients are well-informed about their appointments, providing reminders and rescheduling as necessary. Your contributions will directly impact patient care and satisfaction, making you an essential part of our commitment to No Harm/Quality and outstanding service.

Primary Responsibilities

1. Handle fast-paced volume of inbound and outbound calls in a professional and courteous manner.
2. Schedule patient appointments accurately and efficiently, ensuring optimal use of multiple resources.
3. Communicate through multiple channels, applications while using multiple screens.
4. Coordinate care and schedule referrals between primary care physicians, specialists, and other healthcare providers.
5. Maintain up-to-date patient records and ensure all necessary documentation is completed.
6. Utilize in-depth knowledge of insurance policies, payor plans, par (participating) and non-par (non-participating) status, copays, and coinsurance to accurately process and manage patient referrals.
7. Ensure all referrals are compliant with insurance requirements, verify patient eligibility, and maintain up-to-date records of insurance policies and payor information to support efficient and accurate referral processing.
8. Provide patients with information about their appointments, including location, preparation instructions, and any required documentation.
9. Maintain key performance metrics, such as call volume, appointment scheduling accuracy, and referral turnaround times.
10. Resolve patient inquiries and issues promptly and escalate complex cases to the appropriate personnel.
11. Other duties as assigned.

Work Experience

Minimum Qualifications

• Education: High school diploma or equivalent.
• Work Experience: Minimum 1-2 years experience in a call center, or customer service.
• Licensure: N/A
• Certification: N/A
• Skills/Knowledge/Abilities:

1. General knowledge of healthcare terminology and abbreviations, previous healthcare experience is preferred.
2. Working knowledge of Microsoft Office Suite (Word, Excel, Outlook) and comfortable using electronic health record (EHR) systems.
3. Ability to work effectively in a fast-paced, high volume call center environment and meet performance metrics.
4. Proficiency in typing > 40 WMP.
5. Excellent organizational skills with attention to detail and the ability to prioritize tasks effectively.

Preferred Qualifications

• Education: Associate's degree.
• Work Experience: 3-5 years working in a medical office, scheduling or referral coordination role.
• Licensure: N/A
• Certification: N/A
• Skills/Knowledge/Abilities:

1. Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and comfortable using electronic health record (EHR) systems.
2. Experience working in multiple computer systems simultaneously.
3. Proficiency in using multi-line telephone systems, paging systems, and related office equipment.
4. Strong organizational skills.

Physical Requirements

• Majority of time involves sitting or standing; occasional walking, bending, stooping.
• Long periods of computer time or at workstation.
• Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
• May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise.
• Communicating with others to exchange information.
• Visual acuity and hand-eye coordination to perform tasks.

Benefits

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.