Business Development and Referral Coordinator

American Family Care Ladera Ranch; Mission Viejo (CA); On-site; USD 40,000 - 70,000; Full time

Benefits offered by this job

401(k)

Performance-based bonus

Employee discounts

Health insurance

Opportunity for advancement

Training & development

Job summary

Join a dynamic healthcare team as a Referral Coordinator, where you will play a vital role in managing referral operations and ensuring seamless communication between patients and specialists. This position offers the opportunity to standardize referral processes, work closely with insurance companies, and enhance patient experiences through effective problem-solving. With a focus on critical thinking and exceptional customer service, you will contribute to the overall efficiency of healthcare delivery. If you are passionate about improving patient care and possess strong organizational and communication skills, this role is perfect for you.

Qualifications

• Experience with healthcare referrals and Electronic Health Records is essential.
• Strong knowledge of insurance policies and coding systems is required.

Responsibilities

• Coordinate referral operations and manage health information distribution.
• Ensure timely tracking and prioritization of referrals based on urgency.
• Act as a point of contact for patients and specialists regarding referrals.

Skills

Healthcare referrals

Electronic Health Records (EHR)

Insurance policies knowledge

CPT and ICD-10 knowledge

MS Office proficiency

Critical thinking

Customer service skills

Organizational skills

Job description

Benefits:

• 401(k)
• Bonus based on performance
• Employee discounts
• Health insurance
• Opportunity for advancement
• Training & development

Job Title: Referral Coordinator / Admin Person for WC/EPS

Job Description:

The Referral Coordinator is responsible for referral operations, establishing and standardizing systems and procedures for the distribution and use of health information throughout the organization, coordinating referral functions with all other departments. The Referral Coordinator works with individuals within the organization as well as outside of the organization to coordinate important health-related specialist visits for the patient and is expected to be meticulous in managing and tracking such information.

Essential Duties and Responsibilities:

1. Ensures current referral policies and workflows are standardized, accurate, and up to date.
2. Prioritizes and tracks referrals by their urgency and addresses them in a timely manner.
3. Participates in the selection, orientation, and training of referral personnel.
4. Ensures complete demographic, insurance information, and appropriate/pertaining clinical information is sent to referred specialists.
5. 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.
6. Reviews details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable.
7. Develops and implements systems as required by EMR functionality and/or regulatory agencies.
8. Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.
9. Point of contact for patients and specialists for any questions or rising concerns. Assists in problem-solving potential issues related to their referral due to language or social barriers. If unable to help, assists in finding the right point of contact to further help.
10. Other functions as directed by the Supervisor.

Qualifications:

• Experience with referrals in healthcare preferred
• Experience with Electronic Health Records required
• Proficient knowledge of insurance policies, CPT, and ICD-10 knowledge.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.
• Strong customer service skills, professional attitude, clerical expertise, IT competence, and strong organizational skills.

Weekly Day Range:

Monday to Friday