Referral Coordinator at Harbor Health Services

Role: 

The Referral Coordinator is responsible for processing patient insurance referrals, consultations, and diagnostic procedures relating to patient care which includes knowledge of insurance companies and their covered services. In addition, the Referral Coordinator will act as a Patient Navigator, contacting patients to provide appointment dates and times as well as any necessary testing needs. After training is complete, position may be hybrid with minimum of 3 days in office/on site. 

Responsibilities: 
• Processes referrals/authorizations using appropriate method provided by insurance companies.
• Acts as a liaison between insurance and healthcare providers to ensure required referrals have been processed correctly for medical specialty visits.
• Documents/updates records to ensure all parties have accurate information.
• Communicates with patients to ensure follow-through with referrals or other care related needs.
• Supports care team and patients in synchronizing care with specialist and diagnostics offices.
• Communicates with specialist offices to ensure medical records are received back in a timely manner.
• Accurately charts all information in EHR/EMR.
• Functions as a resource for patients around managed care plans, insurance and referral issues, with an ability to perform electronic insurance verification.
• Schedules appointments, makes follow up calls and documents appointments; faxes referral information to physician offices and diagnostics centers.
• Answers phone calls, takes messages and responds to routine patient, physician and client inquiries.
• Provides support and information to patients and providers to problem solve and manage complex administrative issues.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Ensures that the orders are processed within the department’s service levels.

Requirements: 
• High School diploma or GED
• 2 years of experience working in a professional healthcare environment
• Understanding of HMO, Managed Care, and other Third-Party Insurers
• Knowledge of multiple on-line registration insurances websites
• Electronic Medical Records and Electronic Practice Management experience, EPIC/OCHIN desired
• Knowledge of Medical Terminology required
• Excellent verbal and written communication and customer service skills
• Intermediate computer literacy with Microsoft Office 365: Word, Outlook, Excel and Teams.
• Excellent office machinery skills: faxing, scanning, copying and use of phone system.
• Ability to work independently and as part of a team.
• Ability to prioritize and execute a variety of tasks within a short period of time and work under stressful conditions.
• Must be able to articulate and communicate clearly in English.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.