Referral Coordinator

North Star Health; Boston (MA); On-site; USD 42,000 - 58,000; Full time

Job summary

North Star Health is seeking a Referral Coordinator to manage diagnostic, specialty, and miscellaneous referrals, greet patients, and handle registration, scheduling, and documentation. The role requires handling referrals, authorizations, and communication with providers, patients, and payers while maintaining North Star Health’s customer service standards.

The ideal candidate will have strong organizational, communication, and problem-solving skills, experience in healthcare or customer

Qualifications

• High School diploma or equivalent.
• Prefer experience in a customer service or healthcare related role; working knowledge of medical terminology and HIPAA regulations.

Responsibilities

• Process all referral requests and ensure supporting documentation is available.
• Obtain authorization for referrals and schedule appointments.
• Coordinate with providers, patients, and payers in a team-based manner to ensure timely completion of referrals.
• Manage authorization worklist and all referrals per policy.
• Perform front-end administrative duties and greet patients professionally.
• Handle PHI in accordance with North Star Health policy.

Skills

Customer service

Healthcare terms

HIPAA knowledge

Multi-tasking

Organization

Communication

Problem solving

Teamwork

Education

High school diploma

Job description

Description

About us:

North Star Health is a federally qualified health center located in Southern Vermont and New Hampshire. We are centrally located between larger cities like Boston, NYC, and Montreal Quebec. We are hiring enthusiastic dependable team players with a desire for a rewarding career in the medical field. We value our employees, offer competitive salary and benefits, and understand the importance of work-life balance.

Job Summary:

The Referral Coordinator will manage all diagnostic, specialty, and miscellaneous referral requests. Greet and attend to patients in person and over the phone, ensuring a positive patient experience. Performs all aspects of patient registration, scheduling, document administration and reception while keeping to North Star’s customer service standards. Works in collaboration with team members to deliver high quality care and contribute to a positive work culture.

• Process all diagnostic, specialty, and miscellaneous referral requests (this includes specialty referrals and orders for advanced procedures as defined by “referral”) and ensure appropriate supporting documentation is available to the receiver.
• Obtain authorization for referrals, and schedule appointments for patients as required.
• Ensure current knowledge of insurance prior authorization and referral requirements specific to payers.
• Ensure current knowledge of North Star Health providers, service locations and initiatives.
• Collaborate with providers, patients, and payers in a team-based manner to ensure timely completion of all referral requirements.
• Effectively tracks referrals through identifying that patients were scheduled for the prescribed consult or treatment, attended their appointment, and all necessary information has been received from the specialist.
• Manage authorization worklist.
• Completes all referrals in accordance with established policy and protocol.
• Perform all front-end administrative duties to best meet the needs of our patients in a timely, efficient, competent manner.
• Promptly manages telephone calls professionally, including voicemail, patient portal and answering service messages.
• Schedules patient appointments, following office protocols to ensure appropriate access for patients and maintains the flow in the office.
• Triages phone calls for immediacy of problem and routes messages to nurse or practitioner as appropriate. Takes complete messages with appropriate details according to the Telephone Triage During Business Hours Policy.
• Performs department inbox management function in an organized systematic manner. This function is completed promptly following established guidelines.
• Manages appointment functions such as appointment ticklers, appt reminders, portal scheduling, eligibility, and phone list, wait list, and patient reminder calls.
• Handles all PHI according to North Star Health policy.
• Greets patients in a professional, polite, prompt, helpful, friendly, positive, and welcoming manner. Represent North Star Health in a positive helpful manner.
• Maintains professional composure when met with difficult situations. Avoids personalization and attempts to deescalate. Seeks or helps when appropriate. Exhibit's ability to work under pressure and communicate information accurately.
• Demonstrates flexibility in work schedule and location based on the needs of the organization.
• Show competency in all areas of registration and appointment workflows, including scanning insurance cards, driver's license or other form of identification, obtaining photos, and updating patients' information with each visit. (i.e., name, phone numbers, addresses, emergency contact, guarantor information, all current insurance information with the mailing address, phone number, eligibility and all necessary FQHC required content). Collects co-pays and other patient due balances. Maintains reconciliation of payments.
• Performs all other duties as assigned.
• Adheres to policies and procedures during all activities.

Requirements

Education

• High School diploma or equivalent

Experience:

• Prefer experience in a customer service or healthcare related role, Working knowledge of medical terminology and HIPAA regulations

Knowledge and Abilities:

• Innovative thinker with strong conceptual and problem-solving skills.
• Meticulous attention to detail with the ability to multi-task.
• Strong organizational, administrative, and time-management skills.
• Ability to work under pressure and react effectively to emergency situations.
• Ability to work collaboratively with all team-members.
• Ability to use discretion while working with sensitive information.
• Excellent documentation, communication, and technology skills. Passionate about healthcare excellence

*Must be fully vaccinated against COVID 19 virus and provide required vaccination documentation unless approved for an exemption prior to starting employment. *