Referral Coordinator

Community Hospital Corporation; Gainesville (TX); On-site; USD 34,000 - 42,000; Full time

Job summary

Community Hospital Corporation is seeking a scheduling and referrals coordinator to manage patient referrals, obtain pre-authorizations, and report medical necessity to insurers. You will communicate with clinics, referred clinics, and patients to ensure smooth admissions for inpatients and outpatient procedures.

The role requires familiarity with hospital policies, strong organizational skills, and the ability to handle confidential information with care.

Qualifications

• High school diploma or GED required.
• Prefers at least 6 months experience in a medical office or hospital setting.
• Basic computer skills and ability to type accurately.
• Strong customer service and communication abilities.
• Bi-lingual Spanish preferred.

Responsibilities

• Know hospital policies and be familiar with hospital services.
• Be flexible, organized and function well in stressful situations.
• Treat patients and families with respect and confidentiality of records.
• Interact professionally with patients and families and provide explanations as needed.
• Maintain good relationships within department and with other departments.
• Ensure documentation meets current standards and policies.
• Answer phones politely and relay information to appropriate personnel.
• Obtain prior authorization for testing, procedures and surgeries.
• Detail reasons for denial and possible appeal measures.
• Track referral submissions.
• Maintain spreadsheets detailing procedures and insurance denials/approvals.
• Verify insurance benefits and eligibility before referrals.
• Perform other related duties as assigned by the clinic coordinator/supervisor.

Skills

Basic computer knowledge

Typing with speed

Office machines

Excellent customer service

Bi-lingual Spanish preferred

Education

High school diploma or GED

Job description

JOB SUMMARY

Responsible for scheduling referrals for patients, providers, pre-authorizing and pre-certifying tests/procedures. Reviews clinical data to report medical necessity to insurance companies. Directly communicates with the clinics, referred to clinics and patients. Arranges for efficient and orderly admission of inpatients and admission of individuals who have hospital-based outpatient testing or procedures. Performs all work in accordance to the mission, vision and values of the practice.

Monday - Friday 8a-5p

JOB SUMMARY

Responsible for scheduling referrals for patients, providers, pre-authorizing and pre-certifying tests/procedures. Reviews clinical data to report medical necessity to insurance companies. Directly communicates with the clinics, referred to clinics and patients. Arranges for efficient and orderly admission of inpatients and admission of individuals who have hospital-based outpatient testing or procedures. Performs all work in accordance to the mission, vision and values of the practice.

SUMMARY OF ESSENTIAL JOB FUNCTIONS

• Responsible for knowing hospital policies and being familiar with hospital services that are available.
• Demonstrates an ability to be flexible, organized and function well in stressful situations.
• Treats patients and their families with respect and dignity; ensures confidentiality of patients’ records.
• Interacts professionally with patient/family and provides explanations and verbal reassurance as necessary.
• Maintains good working relationships both within the department and with other departments.
• Ensures that documentation meets current standards and policies.
• Answers the telephone in a polite manner and communicates information to the appropriate personnel/family member.
• Obtain prior authorization for testing, procedures and surgeries.
• Detailing reasons for denial and possible appeal measures.
• Track referral submissions.
• Maintain spreadsheets detailing medical procedures and insurance denials and approvals.
• Verify insurance benefits and eligibility before referring clients.
• Performs other related duties as assigned by the clinic coordinator/supervisor.

BASIC SKILLS

• Basic computer knowledge.
• Ability to type accurately with speed.
• Able to use office machines efficiently.
• Excellent customer service skills.

EDUCATION AND EXPERIENCE

• High school or GED (Required)
• Prefers someone who has at least 6 months experience in a medical office or hospital setting.

LANGUAGE SKILLS

• Ability to effectively communicate both verbally and written
• Bi-lingual (Spanish) preferred

PHYSICAL REQUIREMENTS

• Must be able to life 40 lbs.
• Must be able to stoop, bend or sit for long periods of time.