Job Description

The Referral Coordinator (RC) ensures referral and transition coordination activities. The RC will effectively coordinate customer service requirements with onsite clinical personnel. Performs a key role, as Referral Coordinator and; is consistent, dependable and accurate in carrying out responsibilities to a successful conclusion.

ESSENTIAL 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.

EDUCATION and/or EXPERIENCE:

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