Referral Coordinator

The Referral Coordinator (RC) ensures referral and transition coordination activities. The RC will effectively coordinate customer service requirements with onsite clinical personnel.

Responsibilities

• Performs a key role, as Referral Coordinator and; is consistent, dependable and accurate in carrying out responsibilities to a successful conclusion.
• DUTIES AND RESPONSIBILITIES include the following.
• Other duties may be assigned.
• 1.
• Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
• This tracking may use an IT database.
• 2.
• Ensure complete and accurate registration, including patient demographic and current insurance information.
• 3.
• Assemble information concerning patient's clinical background and referral needs.
• Per referral guidelines, provide appropriate clinical information to specialist.
• 4.
• Contact review organizations and insurance companies to ensure prior approval requirements are met.
• Present necessary medical information such as history, diagnosis and prognosis.
• Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.
• 5.
• Safety and security duties including but not limited to emergency response plans, site audits, evacuation and emergency shelter, facility build-outs, inspections, recycling and facility access.
• 6.
• Review details and expectations about the referral with patients.
• 7.
• Keeps up on technological changes in order to meet today’s new laws and efficiency standards.
• 8.
• Maintains high-level creativity and innovation in the full spectrum of project development, implementation, and operation.
• Continually strives to reduce variations in the existing process that cause failures to meet customer’s needs are requirements.
• 9.
• Assist patients in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• 10.
• Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns.
• May assume advocate role on the patient's behalf with the carrier to ensure approval of the necessary supplies/services for the patient in a timely fashion.
• 11.
• Identify and utilize cultural and community resources.
• Establish and maintain relationships with identified service providers.
• 12.
• Ensure that referrals are addressed in a timely manner.
• 13.
• Remind patients of scheduled appointments via mail or phone.
• 14.
• Ensure that patient's primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
• 15.
• Performs other duties as assigned by Chief Medical Officer.

Preferred

• Completion of an approved program of training for Medical Assistance or other clinical related field.
• Experience in public health and / or outpatient services.