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Duties &
Responsibilities:
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Job Summary
The Referral Coordinator performs a wide range of administrative duties to include referral processing, patient registration, verification of benefits, insurance authorizations, patient appointment scheduling, communication with providers, clinic staff, referral sources and patients.
Duties
- Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
- Ensures complete and accurate registration, including patient demographic and current insurance information.
- Ensure that all referrals are addressed in a timely manner, prioritizing by urgency.
- Ensures current and standardized referral policies and workflows are followed.
- Contacts insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as, history, diagnosis and prognosis to insurance companies if deemed necessary to prove medical necessity of services.
- Reviews details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable.
- Develops and implements systems as required by EMR functionality and/or regulatory agencies.
- Point of contact for patients and specialists for any questions or rising concerns. Assist in problem solving potential issues related to their referral due to language or social barriers. If unable to help, assist in finding the right point of contact to further help.
- Performs all duties in an independent manner with little or no need for direct supervision
- Complies with personnel policies and hospital safety policies
- Performs other duties as assigned
Organizational Expectations
- Provides a positive and professional representation of the organization
- Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention
- Maintains hospital standards for a clean and quiet patient environment to maintain a positive patient care experience
- Adheres to infection-control policies and protocols
- Participates in ongoing quality improvement activities
- Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards
- Complies with organizational and regulatory policies for handling confidential patient information
- Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization
- Adheres to professional standards, hospital policies and procedures, federal, state, and local requirements
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