Referral Coordinator

Position Summary:

The Referral Coordinator is responsible for coordinating and processing patient referrals to specialists, diagnostic facilities, and other healthcare providers. This position ensures that all referral requests are handled efficiently, accurately, and in compliance with clinic policies, insurance requirements, and patient confidentiality standards. This role serves as a liaison between patients, providers, and external offices, ensuring seamless communication and timely scheduling of care.

Essential Functions:

Manage incoming calls and voicemails, ensuring timely and professional responses. Respond to patient and provider messages received through the Electronic Health Record (EHR) system in a timely manner. Document all actions to ensure staff and providers are aware of referral progress and approval information. Process and respond to faxes from specialists related to patient referrals. Prepare and send referrals on behalf of all clinic providers. Obtain pre-authorization, if required, for the patient's treatment Schedule referral appointments and notify patients with appointment details. Submit orders for Cologuard, mammograms, and DEXA scans through appropriate online portals. Enter and track insurance referrals using the TRICARE and BCBS websites. Request and obtain office notes and supporting documentation from specialists. Support insurance compliance by assisting with gap closure requirements for the practice. Maintain consistent communication with nursing, providers, and patients regarding prior authorizations and referrals. Ensure compliance with documentation and data entry protocols. Ensure compliance with healthcare regulations, including HIPAA and relevant state and federal guidelines. Maintain confidentiality and security of patient information. Provide backup coverage for front office phone lines as needed. Maintain the cleanliness and organization of work area. Keep the supervisor informed of any issues or concerns that require attention. Arrive at the office on time and ready to work. Adhere to company policies. Works when scheduled and complies with the company attendance policy. Perform other duties as assigned.

Requirements:

High School education or GED equivalent. Must be able to pass a background check and drug test. Previous experience in a medical office or healthcare setting is preferred. Knowledge of medical terminology, healthcare procedures, and insurance practices is preferred. Familiarity with electronic health record (EHR) systems and medical software. Maintains a professional demeanor in all interactions with patients, family members, providers, office staff, and physician offices. Handle confidential and protected health information (PHI) appropriately, understanding the importance of confidentiality and non-disclosure in accordance with HIPAA guidelines. Good interpersonal and human relations skills are required. Ability to work well under pressure and present oneself in a calm, caring, and professional manner. Detail-oriented, with a focus on accuracy and patient care. Ability to handle multiple tasks in a fast-paced environment. Must have reliable transportation. Ability to work independently, as part of a team, and maintain a positive attitude. Must be able to read, write, and communicate in English effectively.

Physical Requirements/Working Conditions:

Typical business office environment. This role requires extended periods of sitting at a desk while working on a computer, as well as frequent standing and walking to assist patients and manage administrative tasks. It also involves occasional lifting of up to 20 pounds, as well as bending, stooping, and reaching to retrieve and file documents. Must be able to talk, listen, and speak clearly in person and on the telephone. Vision adequate to perform essential functions, such as reading telephone displays/computer terminals, for extended periods. Benefits include employer-paid BCBS medical coverage for employee-only coverage, paid vacation, and paid holidays. No phone calls, please.

Pay:

$33,000.00 - $40,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Paid time off Retirement plan Vision insurance

Work Location:

In person