Referral Coordinator

Referral Coordinator

The Referral Coordinator is responsible for all administrative processing in regard to patient's personal and insurance information for a group of dialysis clinics. This individual cooperates and works closely with both internal and remote co-workers, possesses strong time management skills and the ability to complete assigned job duties with applicable supervisory direction, including exercising job appropriate judgement.

Essential Functions

1.Processes new patient referrals through internal Central Registration System (CRS), ensuring accuracy of patient personal and insurance information.

2.Completes insurance benefit verifications via phone or online verification tools to confirm patient benefits, specific to the referred clinic, to determine acceptance to the clinic.

3.Works with clinic staff to ensure proper documentation for patient verifications is obtained.

4.Works with clinic staff to obtain patient and/or representative signatures on admission documentation as needed.

5.Acts as first point of contact for patient's benefit or network status questions. Escalates difficult conversations as necessary.

6.Ensures completeness and accuracy of patient accounts in billing system, QMS.

7.Resolves billing rejections related to patient demographic information, including working with the patient and/or payer for resolution if necessary.

8.Educates patients on financial responsibility while travelling internationally and drafts corresponding agreements for signature.

9.Initiates requests for authorization as needed based on insurance requirements and clinic network status.

10. Completes and maintains region and/or clinic specific reports.

11. Ensures compliance with CMS coordination of benefits rules.

12. Ensures confidentiality of all data, including patient, employee and operational data.

13. Adapts and is flexible when change arises, alternating between tasks as needed.

14. Stays current with department changes and updates and willingly learns new skills.

15. Handles patient information with discretion and sensitivity and maintains HIPAA compliance.

16. Understands and complies with Medicare rules and regulations, as well as applicable federal, state, agency, region and clinic rules and regulations.

17. Performs other tasks, duties and projects as assigned.

Required Education and Experience

• Bachelor's degree required. Focus in business or healthcare management preferred.

• 0-2 years of experience in similar administrative setting. Combination of degree and work experience will be considered.

• Bilingual in Spanish is helpful, but not required.

• Excellent customer service skills, oral and written communication skills, and ability to actively contribute as a team player with superior attention to detail required.

• Ability to multi-task and work in a fast-paced environment while meeting deadlines and maintaining high standards of accuracy required.

• Proficiency in Microsoft Office Suite required.

Equal Opportunity Employer:

American Renal Associates LLC is an equal opportunity employer and a drug free workplace. All qualified We applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability, or protected veteran status.

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