Job Description

Primary Location:

UofL Hospital - UMC

Address:

530 South Jackson Street Louisville, KY 40202

Shift:

First Shift (United States of America)

Job Description Summary:

About UofL Health:

UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and Brown Cancer Center.

With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.

Job Description:

Position Summary and Purpose

The Referral Coordinator works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits and diagnostic imaging. Responsibilities include: processing referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement; scheduling; and, notifying patients of upcoming appointments.

Essential Functions:

• Gathers, verifies and processes referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers
• Communicates detailed information and answers patients’ questions regarding their health care plan; provide answers to billing and insurance clarification questions
• Sets up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.
• Coordinates flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient
• Enters referrals, documents communication and action into the system, as appropriate
• Notifies physician(s) and patient when referral is denied, or if additional information is needed
• Develops and maintains database of referral physician offices preferred by each physician within the clinic
• Assists manager with complaint resolution and solutions related to patient referral

Other Functions:

• Promptly and professionally answers telephones calls
• Fulfills clerical responsibilities as assigned
• Maintains compliance with all company policies, procedures and standards of conduct
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times
• Performs other duties as assigned

Additional Job Description:

Job Requirements

(Education, Experience, Licensure and Certification)

Education

• High school diploma or equivalent (required)

Experience

• Minimum one (1) year of working in a medical facility with knowledge of health care field and medical office protocols/procedures (preferred)

Licensure:

• None

Certification:

• None

Job Competency:

Knowledge, Skills, and Abilities critical to this role:

• Ability to use multi-line phone system, including transferring calls and paging
• Tact and diplomacy in interpersonal interactions
• Skill in understanding patient education needs by effectively listening and sharing information with patients and families
• Ability to speak clearly and loudly enough to be heard by callers and patients
• Ability to learn and retain information regarding patient care procedures
• Ability to project a pleasant and professional image
• Ability to plan, prioritize and complete delegated tasks
• Ability to demonstrate compassion when dealing with others
• Ability to use computers, phone and fax
• Prevents, calms, or defuses irate callers and patients by working with them to identify concerns and properly direct calls

Language Ability:

• Ability to communicate effectively in both verbal and written formats
• Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations
• Ability too effectively present information and respond to common inquiries or complaints from groups of managers, clients, customers and the general public

Reasoning Ability:

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
• Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form

Computer Skills

• Must be proficient with the Microsoft Office Suite, Internet navigation, database management, desktop publishing, spreadsheet, and graphic presentation packages

Additional Responsibilities:

• Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
• Maintains confidentiality and protects sensitive data at all times
• Adheres to organizational and department specific safety standards and guidelines
• Works collaboratively and supports efforts of team members
• Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community

UofL Health Core Expectation:

At UofL Health, we expect all our employees to live the values of honesty, integrity and compassion and demonstrate these values in their interactions with others and as they deliver excellent patient care by:

• Honoring and caring for the dignity of all persons in mind, body, and spirit
• Ensuring the highest quality of care for those we serve
• Working together as a team to achieve our goals
• Improving continuously by listening, and asking for and responding to feedback
• Seeking new and better ways to meet the needs of those we serve
• Using our resources wisely
• Understanding how each of our roles contributes to the success of UofL Health