Referral Coordinator

Brown University Health; East Providence (RI); On-site; USD 30,000 - 39,000; Full time

Job summary

Brown University Health seeks a referrals coordinator to centralize routine referrals and streamline prior authorizations. The role aims to reduce delays, improve in-network routing, and maintain a preferred provider list.

Responsibilities include managing referrals in eCW for all sites, ensuring forms are completed, obtaining prior authorizations, scheduling appointments, and tracking responses. A strong focus on patient communication and data integrity is required.

Qualifications

• Minimum 3-5 years experience in a medical office setting.
• 1-3 years experience with referrals.
• E-clinical experience preferred.

Responsibilities

• Manage Referral beans in eCW for all sites, both Primary and Specialty Care
• Ensure Referral Request form is completed
• Acquire prior authorization for referrals as needed
• Ensure Referral is received and reviewed
• Schedule referral appointment for patient if not done directly
• Communicate with patient regarding referral appointment provider, time, location, what to expect and what to bring to appointment.
• Track referral response
• Document secondary referrals if indicated
• Attach/Scan Consult Note(s) to medical record
• Close referral when completed

Skills

Medical office experience

Prior authorizations

Referrals management

Tools

eCW (Electronic Medical Record)

Job description

SUMMARY

Coordination of Routine Referrals would be managed centrally to develop a dedicated, trained staff to manage referrals. This would better prepare patients for visit with specialist. Processing referrals would occur within 48 hours and health care cost reductions by directing patients in "In-Network" Providers. The position would help establish and maintain a preferred provider list, standardize patient centric workflow. Develops payer relationships to facilitate prior authorizations, standardize referral content and attachments. Position will help to reduce duplicate or unnecessary tests, prevent delayed diagnosis or treatment, minimize lost referrals and the access backlog.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Consistently applies the Brown Medicine values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Medicine mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Medicine Compliance Program and Code of Conduct.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect, and Excellence as these guide our everyday actions with patients, customers and one another.

• Manage Referral beans in eCW for all sites, both Primary and Specialty Care
• Ensure Referral Request form is completed
• Acquire prior authorization for referrals as needed
• Ensure Referral is received and reviewed

1. Accepted with confirmation of appointment
2. Declined or redirected (not needed, wrong specialty, lack of availability)
3. Patient defers making appointment, declines or cannot be reached (if Specialty is making the appointment)

• Schedule referral appointment for patient if not done directly
• Communicate with patient regarding referral appointment provider, time, location, what to expect and what to bring to appointment.
• Track referral response
• Document secondary referrals if indicated
• Attach/Scan Consult Note(s) to medical record
• Close referral when completed

EXPERIENCE

• Minimum 3-5 years experience in a medical office setting
• E-clinical experience preferred
• 1-3 years experience with referrals

SUPERVISORY RESPONSIBILITY

None.

EEO Statement

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location

East Providence-375 Wampanoag Trail - 375 Wampanoag Trail East Providence, Rhode Island 02915

Work Type

8:30am-5:00pm

Work Shift

Day

Daily Hours

8 hours

Driving Required

No