Referral Coordinator - Rancho Family Medical Group

Job Summary:

The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

The Referral Coordinator is responsible for the coordination and processing of patient referrals and authorizations ordered by the doctors and mid-levels within Rancho. The Referral Coordinator will ensure that patients receive an efficient referral process within a timely manner and answer any questions the staff or patient may have regarding the referral. This position is also responsible for maintaining patient records and confidentiality, managing multiple schedules, and ensuring that patient information is complete and up to date. This job description does not imply that these are the only duties to be performed. They may be required to follow any other instructions and to perform other duties requested by their supervisor based on the needs of the organization.

Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Verify patients' insurance eligibility.
• Contact insurance companies.
• Transfer/ upload information from an order in the EMR to other applications accurately.
• Call and obtain notes from specialists, labs, and/or imaging pertaining to the order.
• Efficiently and accurately attach all relevant information to the authorization.
• Work cooperatively with others, including appropriate communication with patients, providers, support staff and administration.
• Process daily task list that has been created by providers (HMO and PPO insurances).
• Contact patients with any questions and approvals.
• Contact Independent Physician Associate (IPA).
• Order testing is needed to process referral or send tasks to appropriate staff.
• Send medical records to offices to help process requests, as well as authorized copies to patients.
• Assist with scheduling patient appointments with outside providers.
• Troubleshoot and help find solutions for patients denied referrals.

Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.

Minimum Education (or substitute experience) required:

• High school graduate or equivalent.
• 1 year of experience in a medical office or hospital setting.

Minimum Experience:

• Knowledge of medical terminology desired.
• Successful completion of a medical front office program or on the job training with an emphasis on customer service.
• Experience with Microsoft Office software.
• Experience with ICD-10 & CPT coding systems.

Minimum Knowledge and Skills Required:

• Bilingual in Spanish preferred.
• Basic knowledge of frequently ordered diagnostic testing preferred.
• Duties require professional verbal and written communication skills.
• Understanding of principles and practices of the organization, planning, records management, and general administration. Dependability, adaptability, and confidentiality are necessary attributes.
• Ability to work with clinical staff and handle direction from more than one provider.
• Ability to communicate well with IPA’s and PPO insurances, providers, and staff.
• Ability to order tests for patients.
• Customer service skills.
• Politeness, confidence, tact, patience, and diplomacy while dealing with complex and confidential situations. Excellent communication skills. Problem solving skills.
• Ability to maintain a professional and courteous relationship with all members.
• Ability to learn about patients and their problems.
• Integrity and honesty to handle payments and cash drawer.
• Professional communication skills.
• Have compassion and care for patients in their time of need.
• Be willing to work in a dynamic team-based setting where daily job duties may fluctuate depending on need.