Referral Coordinator

About This Role

This role involves planning, organizing, directing, and coordinating all aspects of the referral office within a leading academic medical center. The coordinator monitors daily workflow, ensures timely processing of referrals, and serves as a primary resource for internal and external customers regarding insurance and referral processes.

Responsibilities

• Coordinate and monitor daily workflow processes and activities for meeting required referral insurance deadlines within 72 hours or as directed by the provider
• Daily review and monitor referral work queue to provide accurate and timely referral process documentation
• Serve as the first-line resource for all internal and external customers with regards to insurance and referrals
• Maintain accurate and current referral log on all patients
• Serve as liaison for patients with doctor offices with regards to processing referrals
• Review and analyze managed care patient visits and ensure proper documentation of required services
• Coordinate internal functions and recordkeeping related to managed care organizations to meet compliance
• Ascertain physician credentialing is current and required documentation is on file, in collaboration with staff in LG Patient Financial Services
• Organize in-service programs for staff regarding all referral insurance process changes and updates
• Act as liaison between patient and insurance company to explain what their insurance company requires to meet referral authorization compliance
• Communicate in a positive, customer service manner when communicating with all customers or when using department tools
• Exhibit teamwork and excellent customer service skills without exception, at all times for both internal and external customers
• Collaboratively work with internal and external LG staff, other physician offices, and outside agencies to resolve patient questions and complaints regarding referral insurance issues
• Maintain knowledge of registration and scheduling processes with the capability of filling in as needed based on office workload or staffing demands
• Assist Billing Coordinator with assigned tasks as needed
• Provide educational sessions to resident physicians and staff
• Identify any system dysfunction or discrepancies and report to Supervisor/Manager, making recommendations for improving current department and hospital-wide procedures
• Assist with other projects or responsibilities as required by Supervisor/Manager
• Address gaps in care in an attempt to help patients reconcile any remaining health care screenings or surveillances
• Outreach to patients who express a desire for a new LGHP PCP to schedule an appointment
• Outreach to patients who have not been seen within the prior 18 months at their LGHP PCP office and schedule patients accordingly to maintain their LGHP relationship