Referral Coordinator

Eye Specialists of Mid Florida; Winter Haven (FL); On-site; USD 22,000 - 33,000; Full time

Benefits offered by this job

401(k)

Health Insurance

Health Savings Account

Disability Insurance

Vision Benefits & Discounted Services

Paid Time Off

Paid Training

Professional Development Assistance

Job summary

Eye Specialists of Mid Florida is seeking a Referral Coordinator to ensure authorizations and referrals are obtained before patient visits and to process referrals on behalf of patients to other specialists.

The role requires knowledge of ophthalmic insurance verification, Medicare/Medicaid, and CPT coding, with a focus on accurate data entry and strong communication with physicians.

Qualifications

• High school diploma or GED required.
• Bachelor or Associate Degree preferred.
• One year experience in an Ophthalmic setting required.
• Experience in Ophthalmic insurance verification preferred.

Responsibilities

• Retrieve the appointment list five to seven days before the visit and review each account.
• Verify whether a referral or authorization is on file or if a new request is needed.
• Create a referral or authorization request with CPT codes and send with chart notes for approval.
• Maintain a running log of requests and follow up on pending referrals/authorizations.
• Communicate with physicians and specialists to obtain referrals or authorizations as needed.
• Document authorization details in the patient record and update demographics/insurance information.
• Enter demographics, referrals, authorizations, and patient data into the practice management software.
• Assist emergency walk-in patients with insurance referrals or authorizations.
• Scan referrals or authorizations into patient demographics in the system.
• Attend trainings and contribute to professional development and performance goals.
• Support excellent customer service and represent the practice positively.

Skills

Problem solving

Detail-oriented

Medicare/Medicaid knowledge

ICD-9/10 CPT Coding Ophthalmology

Communication skills

Team-oriented

Multi-tasking in fast-paced env

HIPAA compliance

Practice management software

Education

High school diploma or GED

Bachelor or Associate Degree preferred

Tools

Practice management software

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Regular - Hourly Full-Time Clerical Winter Haven, FL, US

POSITION SUMMARY

The Referral Coordinator is responsible for ensuring that authorizations and referrals are properly obtained prior to the patients arriving for their appointment. The coordinator is also responsible for processing any authorizations and referrals on behalf of the patient to another specialist provider.

MINIMUM QUALIFICATIONS

Education and Experience:

• High school diploma or GED required
• Bachelor or Associate Degree preferred
• One year experience in an Ophthalmic setting required
• Experience in Ophthalmic insurance verification preferred

ESSENTIAL SKILLS AND ABILITIES

• Ability to problem solve
• Detail-oriented
• Understanding of Medicare, Medicaid, and other commercial insurance
• Comprehensive knowledge of Medicare, Medicaid, HMO, and Commercial Insurance plans and eligibility requirements
• Familiar with ICD-9/10 and CPT Coding for Ophthalmology
• Excellent communication skills, proper grammar, and writing capability
• Team-oriented
• Self-directed, highly motivated, and able to multi-task in a fast-paced environment
• Capable of handling multiple projects accurately and efficiently
• Exceptional interpersonal skills
• Caring, patient, and friendly attitude
• Familiarity with all forms (paper & electronic) associated with the patient’s medical record
• Understanding of ophthalmic terms and spelling
• General knowledge of ophthalmic diseases

DUTIES AND RESPONSIBILITIES

• Retrieves the appointment list of patients by running appropriate reports five to seven days before the visit and review each account.
• Verify whether we have a referral or authorization already on file or if a new request needs to be created.
• Creating a referral or authorization request using the CPT Procedure code fax form and sending it with all appropriate patient chart notes for approval to the primary care physician.
• Keeping a running log of what has been requested from the primary care physicians and following up on the requests if the referral or authorizations have not been received.
• Communicates with the primary care physicians or other specialists' providers in a pleasant and expeditious manner for any referral or authorization requests and/or troubleshooting
• Properly documents authorization details in the patient’s “alert” section of the medical record
• Correct any demographic or insurance information that is not accurate
• Input any demographics, referrals, authorizations, or patient information into the practice management software.
• Obtains insurance referrals or authorization for emergency walk-in patients
• Scan referrals or authorizations into the patients' demographics in the practice management software
• Professional and Personal Development/Goals and Objectives
• Exhibits professional demeanor with a positive, enthusiastic attitude at all times when representing the practice
• Must attend all in-services and webinar training seminars as directed by the Manager
• Sets goals and objectives for professional growth. Reviews and revises goals on an ongoing basis
• Provides input on how to improve customer service, decrease costs and increase revenues for the practice
• Customer Service
• Supports the practice core values and mission statement to develop, enhance, and promote quality customer service through team effort
• Exhibits flexibility, sensitivity, and respect while maintaining an effective working relationship with all team members
• Maintains practice confidentiality, follows HIPAA & OSHA guidelines, and follows the rules and regulations of the practice as documented in the practice employee manual
• Maintains proper standards of productivity as defined by management
• Completes any additional tasks and responsibilities as noted in the pay for performance program
• Assumes other duties as assigned

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential function of this job

• The majority of the time on the job is spent walking, sitting for long periods, reaching with hands and arms, talking, hearing, stooping, crouching and bending
• At times the job may require weight to be lifted up to 25 pounds
• The job requires the following types of vision: close, distance, peripheral and depth perception
• Typical noise level for the work environment of this job is moderate (i.e. business office with computers and printers, light traffic)
• Work in an office environment and sustain posture in a seated position for extensive periods of time
• Must be able to communicate clearly and professionally in person and over the phone
• Hearing must be adequate to perform job duties in person and over the telephone
• Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions

JOB TYPE

• Full-Time
• In Person, Winter Haven

SUPERVISORY RESPONSIBILITIES

None

BENEFITS

• 401(k)
• 401(k) Matching
• AD&D Insurance
• Health Insurance
• Health Savings Account
• Disability Insurance
• Vision Benefits & Discounted Services
• Employee Assistance Program
• Employee Discount
• Life Insurance
• Opportunities for Advancement
• Paid Time Off
• Paid Training
• Professional Development Assistance
• Referral Program

OTHER

This job description is intended only to describe the general nature and level of work performed. The Referral Coordinator must be able to travel to various satellite locations as needed for work assignments. A valid Florida driver’s license is required. This job description is not intended nor should it be interpreted as an exhaustive list of all duties, skills, and responsibilities. The Referral Coordinator will perform all duties listed in this job description as well as any other assigned by the departmental supervisor. Overtime may be required.

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

Eye Specialists of Mid-Florida P.A. is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. We are a drug and tobacco-free workplace.