Referral Coordinator

Position Title

Referral Coordinator

Delp Pavilion

Position Summary / Career Interest:

The referral coordinator is responsible for ensuring that referrals and the work queue are worked and addressed in accordance with Health System standards, including reporting any issues with incoming referrals to the appropriate person, gathering outside records, and coordinating required testing. Works with insurance companies to obtain prior authorization for referrals and various procedures. Coordination with referring physician's office, patient, and other departments as needed to get appointment scheduled appropriately.

Responsibilities:

• Manage and assign all referrals in work queue to referral team using critical thinking and delegation skills. Work cooperatively with providers and call center to obtain, assess, and respond to external information

• Attend meetings and participate in Committees as required, specifically those related to scheduling and key performance indicators as they relate to patient access, scheduling, patient and employee engagement.

• Maintain patient confidentiality.

• Provide education to patients about the importance of the referral process and service provided by the physician's office, which may include sub-specialty focus, collaborative efforts between provides, gathering and providing information key to appointment success.

• Supports Scheduling Supervisor by providing recommendations appropriate for improvement strategies key to department scheduling success that also improves patient access, patient experience, and physician clinic experience. Implements, maintains, and manages approved strategies. Understands the up-stream and down-stream impact to scheduling changes making necessary modifications if necessary.

• Work with supervisor, manager, and administrator to make recommendations regarding department referral documentation, organizational improvement, information and staffing retention, etc.

• Communicates to physicians and other health care providers the various requirements and processes involved with medical referral authorizations for the most expedient patient appointment and successful visit.

• Utilize the EMR system to its full potential in capturing the necessary information needed for making an appointment and communicating necessary information such as referral shells, patient demographic information, insurance and approval information, comments about specific patient information key to a successful appointment.

• Work with scheduling supervisor to implement and manage identified key metrics regarding timely referral completion, holding scheduling team accountable.

• Work with Workman's Compensation team to appropriately route patients to providers for prompt scheduling

• Monitor Acute Line voicemail to follow up with acute line calls that come in after hours, or assign to others on the scheduling team to schedule

• Close referrals with proper documentation and send letters to patients informing of referral status

• Manage log of all assigned referrals to ensure equitable distribution to all providers. Follow established distribution rotations as identified by Chair, administrator, manager, and supervisor.

• Manage weekly reports regarding employee performance of the scheduling team. Validate and ensure work is completed. Identify barriers and gaps in work product and implement strategies for improvement and success, which may include work re-distribution, changes in work flow, or the need for additional resources. Once metrics are implemented, utilize metrics to determine necessary increases in work force.

• Maintain schedules and rotations for scheduling team. Develop, implement and manage standard coverage requirements for scheduling and referrals that includes coverage during PTO or sick time so that there is no gap in service to patient or referral customer. Establish rotations within the scheduling team for a more well-rounded coverage model.

• Thorough understanding of the scheduling process and ability to train new members of the scheduling team. Provide insight to committees about scheduling improvements to the EMR system. Work with supervisor to implement and manage a scheduling training manual for schedulers in the department.

• Act as indirect supervisor when scheduling supervisor is unavailable. Assist supervisor in daily operations of the scheduling team.

• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

• Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

JOB REQUIREMENTS

Required:

• High School education or equivalent

• Minimum of two years of medical office experience in a managed care environment, with at least one year actively involved in referrals

Preferred:

• Medical terminology- specifically orthopedic base

• Medical certification- M.A., CNA, Ortho Tech, etc.

Time Type:

Full time

Job Requisition ID:

R-32987

We are an equal employment opportunity employer without regard to a person's race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.

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