Referral Coordinator

Central Florida Health Care; Winter Haven (FL); On-site; USD 36,000 - 48,000; Full time

Job summary

Central Florida Health Care, Inc. seeks a Referral Coordinator to manage the patient referral process, coordinate referrals ordered by CFHC providers, verify third-party information, secure appointments, and track referrals for timely care.

The role also involves training new staff, serving as an Outreach Liaison to specialist offices, and acting as a back-up for the Referral Specialist, while adhering to CFHC policies and regulatory requirements.

Qualifications

• High School diploma or GED required
• Certified Medical Assistant preferred
• Experience preferred
• Computer literacy
• Knowledge of basic medical terminology
• Knowledge of various insurance programs (e.g. Medicaid)
• Strong customer service focus
• Effective verbal and written communication
• Organized and able to manage competing priorities
• Resourcefulness in problem solving
• Able to take and follow through with delegated tasks
• Team oriented

Responsibilities

• Be familiar with CFHC’s program philosophies, goals and objectives; comply with policies and procedures and regulations
• Coordinate all aspects of completing referrals ordered by CFHC providers
• Complete referrals in a timely manner: STAT by end of business day; URGENT within 24 hours; ROUTINE within 72 hours
• Obtain authorizations from insurance companies and gather necessary documentation
• Schedule referral appointments for patients and ensure proper paperwork is provided
• Notify patient of scheduled referral appointment
• Document appropriately and thoroughly
• Track referrals to improve quality and continuity of care
• Notify ordering provider or Referral Specialist Supervisor of problems in referral process
• Maintain specialty provider list and review referral logs
• Train new hires, providers, and nursing staff
• Serve as Outreach Liaison to specialist offices
• Back up Referral Specialist during vacations
• Other duties as assigned by Referral Specialist Supervisor

Skills

Medical terminology

Insurance programs (Medicaid)

Customer service

Verbal & written communication

Organization & prioritization

Problem solving

Task follow-through

Team oriented

Education

High School diploma or GED

Certified Medical Assistant preferred

Job description

Title: Referral Coordinator

Reports to: Referral Specialist Supervisor

FLSA Status: Non-Exempt

Personnel Supervised: None

POSITION SUMMARY

The Referral Coordinator is responsible for performing all aspects of the patient referral process including coordinating and completing referrals ordered by CFHC providers, acquiring, and verifying third party information for referrals, obtaining referral appointments, tracking referrals, training new hires and providers. The Referral Coordinator will have the responsibilities as an Outreach Liaison and Team Lead.

MINIMAL QUALIFICATIONS

• Certified and Registered Medical Assistants preferred High School graduate or GED required
• Experience preferred
• Computer literacy

KNOWLEDGE AND SKILLS

• Knowledge of basic medical terminology
• Knowledge of various insurance programs (example, Medicaid)
• Strong customer service focus
• Effective verbal and written communication skills
• Organized and able to manage competing priorities
• Resourcefulness in problem solving
• Able to take and follow through with delegated tasks
• Team oriented

RESPONSIBILITIES AND PERFORMANCE EXPECTATIONS

• Be familiar with CFHC’s program philosophies, goals and objectives. Be cognizant of and comply with all CFHC’s policies and procedures, as well as state and federal regulations.
• Be competent in performing the duties of a referral specialist.
• Report as needed to CMO any pertinent information or situations that impact on patient care or CFHC liability.
• Attend and participate in mandatory CFHC meetings (Center Specific meetings, Corporate meetings, and other meetings as designated by the CMO or CEO).
• Demonstrate ability to work cooperatively with other members of the clinical team. Be supportive of coworkers.
• Maintain a neat and professional appearance at all times.
• Carry out any other activities deemed appropriate by the CMO or CEO.
• Coordinate all aspects of completing referrals ordered by CFHC providers.
• Complete referrals in a timely manner; STAT referrals must be completed by end of business day, URGENT referrals within 24 hours, and ROUTINE referrals within 72 hours.
• Obtain appropriate authorizations from insurance companies sending necessary documentation from the patient’s medical record as required.
• Schedule referral appointments for patient (when applicable) ensuring proper paperwork is faxed to the specialist or given to the patient to take to the appointment (example, labs, x-ray reports, progress notes).
• Notify patient of scheduled referral appointment.
• Document appropriately and thoroughly.
• Track all referrals accordingly to improve the quality and continuity of care provided to patients. This includes, but is not limited to, initiating reminder calls to patients prior to their scheduled appointment and obtaining the referral report from the specialist.
• Notify the ordering provider and/or Referral Specialist Supervisor of any problems in obtaining a patient’s referral, including issues with obtaining authorizations from third party payors or making appointments with a specialist, patient refusal of a referral, or patient no show to scheduled referral appointment.
• Maintain specialty provider list including payor sources they accept.
• Review referral log weekly to ensure completion of all referrals.
• Be the point of contact when supervisor is out of the office/vacation.
• Train new hires, providers, and nursing staff.
• Serve as an Outreach Liaison going to specialist offices to obtain necessary information.
• Serve as a back up to referral specialist out on vacation.
• Other duties as assigned by Referral Specialist Supervisor.

PHYSICAL REQUIREMENTS

• Requires 80% or more time spent sedentary.
• Independently mobile.
• Ability to lift weight equivalents that would be required with repositioning equipment and lifting supplies.
• Ability to adapt and function in varying environments of workload, patient acuity, worksites, and work shifts.

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.