Patient Referral Navigator

Claremedica Health Partners; Deerfield Beach (FL); On-site; USD 36,000 - 48,000; Full time

Job summary

Claremedica Health Partners in Deerfield Beach, FL is seeking a Referral Coordinator to schedule referrals, gather patient information, and coordinate with outside specialists. You will manage referrals, track documentation, and communicate effectively with patients and providers to ensure timely care.

The role requires strong organizational and communication skills, HIPAA knowledge, and experience with EMR systems.

Qualifications

• High school diploma, GED or equivalent experience required.
• Minimum of 1 year of experience processing referrals, as an MA or other clinical/front desk experience preferred.
• Educated on and compliant with HIPAA regulations; maintains strict confidentiality of client information.
• Exceptional oral and written communication skills, time management skills and organizational skills.
• Ability to communicate with employees, patients and other individuals in a professional and courteous manner.

Responsibilities

• Schedules, solves problems, communicates, and coordinates referral appointments with outside specialists upon receipt of the Referral Order from designated Claremedica Provider.
• Maintains a current working knowledge of all health plan carrier requirements for referral request authorizations and approval requirements.
• Provide excellent service and attention to customers when face-to-face or through phone conversations.
• Schedule initial and follow up appointments for specialist and imaging facilities.
• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
• Assemble information concerning patient's clinical background and referral needs.
• Per referral guidelines, provide appropriate clinical information to specialists.
• Contact review organizations and insurance companies to ensure prior approval requirements are met.
• Present necessary medical information such as history, diagnosis, and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians, including requesting medical records as needed.
• Review details and expectations about the referral with patients.
• Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. 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.
• Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers.
• Ensure that referrals are addressed in a timely manner.
• Remind patients of scheduled appointments via mail or phone.
• Misc. administrative tasks as required by the Referral Management Supervisor.

Skills

Communication skills

Organizational skills

Problem solving

Bilingual a plus

Education

High school diploma, GED or equivalent

Tools

Microsoft Office Suite

EMR system

Excel

Word

Outlook

PowerPoint

Job description

Claremedica Health Partners in Deerfield Beach, FL is seeking a Referral Coordinator to schedule referrals, gather patient information, and coordinate with outside specialists. You will manage referrals, track documentation, and communicate effectively with patients and providers to ensure timely care.

The role requires strong organizational and communication skills, HIPAA knowledge, and experience with EMR systems.