Referral Authorization Coordinator - Touro University California

Overview:

The Referral Authorization Coordinator position performs a wide range of administrative duties to include referral processing, patient registration, verification of benefits, insurance authorizations, patient appointment scheduling, program communication to potential candidates, communication with referral sources and other tasks assigned. They are often the first point of phone contact for our patients, referring physicians and their staff, as well as hospital staff, patient family members and vendors.  The Referral Authorization Coordinator may also be asked to perform other clerical duties as needed and requested to support daily clinic operation goals, benchmarks, and quality patient care initiatives per departmental guidelines.  This position will have access to third party credit card information and transactional systems (point of sale devices or applications supporting credit card transactions, reports or other documents containing credit card information) from single transactions.

Responsibilities:

• Documents incoming referrals and continues to monitor and update as appropriate until the referral culminates with an appointment or denial.
• Coordinates with others as appropriate and documents any additional details to reflect the lifespan of the referral.
• Keeps patient informed about appointment delays and offers solutions in a timely manner.
• Completes and closes out referrals as directed to ensure completion.
• Consistently demonstrates competence as outlined in this job description and in accordance with the employee handbook.
• Sorts incoming emails, medical records and referrals and provides to appropriate physician or staff and coordinating with them for follow up/completion.
• Processes eligibility checks to make sure patient is eligible for services to be rendered.
• Completes faxes to internal and external offices to send documents as required.
• After review of referral, as needed by the specialist, books appointment, notifies patient, and ensures appropriate paperwork is sent to the patient in timely manner.
• Addresses problems involving patient, families and the general public in accordance with Clinic policies and procedures.
• Scans and imports incoming clinical documentation into Electronic Health Records in a timely manner in accordance with clinic protocol.
• Answers telephone, screens calls, takes messages, provides answers within job scope and provides information effectively and efficiently.
• Helps at front desk to check in and check out patients as needed.
• Demonstrates ability to adapt to any expected work duty changes in a positive manner within TUMG due to dynamic Referral Department workflow process and/or procedures.
• Engages in professional business-related conversations in patient care areas and avoids personal conversations where patients may hear them.
• Attends all required training, meets OSHA (Occupational Safety and Health Administration) standards, can verbalize fire/disaster plan.
• Applies safe work practices and precautions in accordance with Infection Control guidelines.
• Adheres to all patient HIPAA (Healthcare Insurance Portability and Accountability Act) confidentiality requirements.
• Assists other employees as needed
• Other duties as assigned.

Qualifications:

High School diploma or equivalent. A minimum of three (3) years of experience in an outpatient setting as a Referral Authorization Coordinator. Excellent interpersonal, organizational and customer services skills are essential.  Bilingual English/ Spanish preferred. Computer literate, especially re: Healthcare EMR and Practice Management systems. Ability to work with multi-ethnic population

 

 

CORE COMPETENCIES:  Core competencies identify the behavior an employee is expected to demonstrate.

Knowledge, Skills and Abilities:

 

Excellent Interpersonal, organizational, and customer service skills are essential. Ability to utilize computer equipment and software are required as is experience with other types of standard office equipment. Routes, manages, prioritizes and completes tasks every hour or per specific expectations as outlined by the Clinic guidelines. Routes appropriate tasks when applicable to the proper individual/group as outlined by Clinic guidelines. Takes responsibility for his/her own actions.  Knows and complies with applicable laws and rules including federal health care program requirements, the TUMG Standards of Conduct, policies and procedures as they apply to his/her particular job responsibilities. Seeks guidance when in doubt about his/her responsibilities.  Refrains from involvement in illegal, unethical or otherwise improper acts. Promptly reports any potential or suspected violation of TUMG Standards of Conduct, policy or applicable laws or regulations.  As requested, assists TUMG personnel and authorized outside personnel in investigating all allegations of violations. Understands and accepts the consequences for failure to comply with TUMG Standards of Conduct. Consistently serves as an example of superior customer service with a professional demeanor. Keeps their Supervisor informed of workflow issues that need attention in a timely manner. Maintains open communication with medical staff to ensure continuity of care for each patient. Efficiently and independently plans time to accomplish job duties within departmental standards. Employee is punctual, meets deadlines, initiates and follows through on tasks. Demonstrates sensitivity to people of different cultures and works effectively with them. Consistently makes eye contact and smiles. Ensures smooth daily operations and steady progress towards established clinic goals. Seeks necessary approvals as required.

Maximum Salary:USD $49,400.00/Yr.Minimum Salary:USD $39,520.00/Yr.