Job Summary
We are seeking a proactive and detail-oriented Referral Coordinator to join our dynamic healthcare team. In this vital role, you will serve as the primary point of contact for managing patient referrals, ensuring seamless communication between providers, insurance companies, and patients. Your expertise will help facilitate timely access to specialized care while maintaining strict adherence to confidentiality and healthcare regulations. This position offers an exciting opportunity to contribute to improved patient outcomes through efficient referral processes and exceptional customer service.
Duties
- Coordinate and process patient referrals by verifying insurance coverage and eligibility, ensuring all necessary documentation is complete and accurate.
- Communicate effectively with healthcare providers, insurance companies, and patients to facilitate appointment scheduling and follow-up.
- Obtain prior authorization from insurance carriers for specialized services, adhering to managed care policies and health insurance requirements.
- Maintain comprehensive medical records and electronic health records (EHR), ensuring compliance with HIPAA privacy standards and clinical confidentiality policies.
- Utilize medical coding systems such as CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to accurately document services rendered.
- Verify insurance benefits, including health insurance policy details, to confirm coverage for procedures and services.
- Manage electronic health records (EHR) systems using Microsoft Office tools when necessary for documentation or reporting purposes.
- Provide excellent customer service by addressing patient inquiries promptly, explaining referral procedures clearly, and supporting their navigation through the healthcare process.
- Collaborate with medical office staff to ensure smooth workflow in medical billing, insurance verification, and medical records management.
- Follows up on referrals with Specialty Providers and Patients.
- Attends and participates in required meetings.
- Ensures client-patient confidentiality.
- Other duties and/or special projects as assigned.
Experience
- Prior experience working in a medical office environment or healthcare setting is required, preferably with dental or outpatient clinics.
- Knowledge of health insurance policies, managed care processes, and prior authorization procedures is essential.
- Familiarity with medical terminology, medical coding (CPT, ICD-9/10), and electronic health record (EHR) management is highly desirable.
- Experience with insurance verification processes and understanding of health insurance policies will enhance your effectiveness in this role.
- Strong customer service skills with the ability to communicate complex information clearly and professionally are necessary.
- Proficiency in Microsoft Office applications such as Word and Excel is preferred for documentation purposes.
- Knowledge of clinical confidentiality policies and HIPAA regulations is mandatory to ensure patient privacy at all times.
- Join us as a Referral Coordinator to be a crucial part of delivering exceptional healthcare experiences! Your dedication will help streamline referral processes, improve patient access to care, and uphold the highest standards of confidentiality and professionalism in our organization.
Pay: From $18.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- Are you knowledgeable/familiar with all types of Insurances?
Education:
- High school or equivalent (Required)
Experience:
- eClinicalWorks: 2 years (Required)
Language:
- English & Spanish (Required)
Work Location: In person
