Referral Coordinator

Overview

JOB TITLE: Referral Coordinator

DEPARTMENT: Case Management

REPORTS TO: Case Management Supervisor

POSITION OVERVIEW:

The referral case coordinator’s obligations of duties can be found summarized below.

• Responsible to monitor and oversee the patient referral system.
• Shall process and monitor all patient referrals and managed care authorization requests.
• Shall ensure that all initiated referrals or authorizations received are accurately and thoroughly completed as required prior to submission (in efforts to avoid delays).
• Insures that all referrals authorization requests are scanned within a timely manner (urgent, routine, etc.).
• Ensures that referrals and authorization requests are filed appropriately and maintained in the patient’s electronic health record.
• Shall maintain a record of all referrals process in |2| software. Record shall include: patients name, Chart #, date referral was faxed or mailed, date of appointment, if patient kept the appointment, authorization # (if applicable).
• Will maintain a list of referral sources and contacts.
• Shall ensure to request Release of Records (R.O.R. from Specialists) for all appointments or referrals made and will make every effort to ensure the receipt of the R.O.R.’s.
• Will forward R.O.R.’s to the applicable provider for review and approval prior to filing the documents in the patient E.H.R.
• Responsible to keep department records in an organized and orderly fashion (files, binders, etc.).
• Will inform supervisor regarding any grievances related to an IPA, HMO, hospital, or other facilities.
• Shall follow-up on all patients referred to the Emergency Room (ER) by an FHCCGLA provider or who had a recent E.R. visit.
• All other duties assigned.

MINIMUM QUALIFICATIONS:

• High school diploma, minimum (or GED equivalent).
• Medical Assistant Certificate (Preferred).
• Requires exceptional organizational skills.
• Computer literate.
• Spanish speaking required.
• Strong communication, interpersonal skills, and problem solving skills.
• Ability to take initiative in performing and completing tasks.
• Ability to prioritize workload and work under pressure of deadlines.
• Willingness to adapt to changes in clinic schedules, agency growth and expansion.

ADDITIONAL ELIGIBILITY QUALIFICATIONS
:

• Ability to work well with others in a professional and team-oriented environment.
• Well-developed interpersonal skills, friendly personality and able to motivate staff by promoting teamwork.
• Ability to relate to the public regardless of ethnic, religion and economic status.
• Excellent communication skills.
• Willingness to travel.
• Strong planning and organizational skills.
• Problem analysis and critical thinking skills.
• Excellent customer service skills.
• Knowledge of the following (but not limited to), preferred:
• My Health LA PPO’s HMO’s
• Medicare Family PACT CPSP
• Medi-Cal Fee-for-Service CHDP
• Managed Care Plans Every Woman Counts