Creates and assists with the preparation of referral requests. As part of the preparation process will verify eligibility, benefits, request any needed clinical notes and accurately complete or forward referral to appropriate staff to finalize decision. Ensures that all referral policies and procedures are followed as required to meet all contractual, regulatory and federal requirements
Essential Functions and Responsibilities of the Job
Research and process incoming referral requests received via fax or system generated
Check HP eligibility and benefits as needed
Gather clinical notes and HP criteria as needed
Scan and attach faxed clinical information
Demonstrate good problem-solving skills
Provide a high standard of customer service for Patients, Physicians and Staff
Demonstrate professional and courteous communication skills. Supports a collaborative and cooperative environment when working with others to facilitate mutual respect and effective interpersonal relations.
Meet all department standards
Responsible for running daily reports to capture all work stream referrals including; urgent/emergent referrals, ASA referrals, portal referrals and indemnity/PPO submissions, ODAG reports, inpatient daily census/authorization logs if work location is inpatient related, and other requested ad hoc reports for utilization, productivity and operational metrics.
Assist providers, patients, other departments regarding issues related to referrals
Responsible for the coordination of PCC meetings, by preparing agenda, roster, distribution of reports, food orders, scheduling guests, scheduling meeting time and room preparation if work location is at clinic site.
Ability to be at work and on time
Ability to follow company policies, procedures and directives
Ability to interact in a positive and constructive manner
Ability to prioritize and multitask with attention to detail and timeliness for task completion.
Perform any additional duties that may not be inclusive in job description as requested by Management team that is within the scope of knowledge or ability of the Referral Coordinator.
Able to travel to other clinics to cover staffing needs and training.
Telecommuting (full or part time) may be an option and is based on business necessity, functional area, productivity measures and availability of resources. Administration of this option will be in line with Telecommuting Policy, Reference # HR344.”