Contact Center Referral Coordinator

Job Description Job Description Job Summary : The Referral Coordinator is responsible for efficiently managing referrals from outside providers to ensure proper authorization and payments for services. About the Practice: The physicians of Heaton Eye Associates have been serving East Texas’ vision needs for over 40 years. We offer state-of-the-art technology with special services ranging from primary eye care to world-class laser surgery. Our physicians were the first to offer LASIK laser vision correction in East Texas and have performed tens of thousands of procedures since its inception. Heaton Eye offers a wide range of premium lenses including Symfony Extended Depth of Focus lenses, PanOptix® lenses, and Vivity® lenses to offer freedom from glasses and contacts after cataract surgery. Our surgeons were the first in East Texas to offer the RxSight Light Adjustable Lens, the only lens implant that allows patients to preview and adjust their vision after cataract surgery. We are the first and only practice in the area offering EVO ICL, another exciting option offering patients freedom from contacts and glasses. Additionally, we have the only fellowship-trained Pediatric Specialist as well as the only Oculoplastic Surgeon offering cosmetic, medical, and reconstructive surgery as well as state-of-the-art aesthetic services in the area. The extensive care and energy Heaton Eye Associates puts into maintaining our leadership position on information and technology in the rapidly evolving science of ophthalmology reflects our commitment to our patients. About the Area: Our East Texas locations in Tyler, Longview and Athens offer year-round activities the entire family can enjoy. In Longview, you can experience Texas' rich history and culture. Tyler is surrounded by 25 prime sporting lakes, offering wonderful opportunities for fishing and boating. In the spring, Tyler residents enjoy the colorful spring flowers. Athens, whose tagline is Hamburgers-Heritage-Texas, has the charm of a small, southern town while still retaining many qualities of a larger city and is home to the East Texas Arboretum and Botanical Society. Experience: NextGen experience preferred Insurance Verification: 2 years’ experience Experience processing/managing referrals: 2 years’ experience, demonstrating production and accuracy Certification/Licensure: None Required Education: High School Diploma or equivalent Job Duties Include: Receives referral requests from providers and Health Plans, as needed. Verifies member’s eligibility and benefits with timely notification to designated staff of eligibility issues. Inputs all requests for services received via fax or phone into the system accurately for electronically generated authorization and tracking. Notifies required parties within the appropriate timeframe for routine and urgent requests for services. Research member history for duplications and consideration of referral limits. Provides effective departmental communication with both internal and external sources. Forwards referrals to appropriate department staff in terms of eligibility, other coverage, and benefit issues. Scans, attaches, reviews and effectively works with electronic images as part of the authorization process. This includes recording the required information from attachments into the authorization fields in NextGen. Collaborate with team lead and supervisor to resolve complex referral issues. Appropriately forwards all referral requests to the next level of clinical review as applicable and after verifying for completeness and appropriateness. Documents and communicates areas of concern to supervisor. Adheres to company HIPAA policies and procedures. Identifies, maintains and protects sensitive HIPAA information (PHI) and follows procedures to ensure the security of such information. Qualifications and Skills: Required: computer literacy and advanced data entry capacity (+45 wpm) Must obtain NextGen or other similar medical office software Basic keyboarding Knowledge of practice management software General office equipment Positive attitude Dependable, multi-task oriented Excellent communication skills Organized Excellent phone skills Benefits: Affordable Health and Dental Vision Care Life Insurance PTO 401K