Medical Referral Clerk

PRINCIPAL DUTIES AND RESPONSIBILITIES:

* Coordinate and schedule all diagnostic testing and specialty consultations, both internal and external.

* Daily reports of referrals and diagnostic procedures are generated from the previous day to ensure prompt follow-up and resolution of pending items

* Ensure appropriate pre-authorization and referral procedures are followed according to payer guidelines.

* Serve as a liaison between patients, providers, and external specialists to ensure clear communication and timely appointments.

* Obtain medical records and consultation reports from external facilities where Betances has system access; attach and assign reports in the EHR as appropriate.

* Accurately document and maintain all referral information within the Electronic Health Record (EHR) and Practice Management system.

* Monitor and track the status of all referrals to ensure follow-through, receipt of consultation reports, and closure in the EHR.

* Communicate referral and appointment details to patients, providing instructions and answering questions regarding next steps.

* Follow up with providers or departments to obtain necessary documentation for pre-authorizations and referrals.

* Support internal departments with referral-related questions and ensure coordination of care between service lines.

* Generate and maintain referral tracking reports to support quality assurance and compliance initiatives.

* Participate in special projects, process improvement activities, and staff training as assigned.

* Perform other duties as directed by the supervisor or Executive Management Team.

KNOWLEDGE, EDUCATION,

SKILLS AND ABILITIES

REQUIRED:

* High School Diploma or GED equivalent required;

* One (1) year + experience in a clinical or healthcare setting;

* Excellent customer service and telephone skills;

* Bilingual English/Spanish preferred;

* Excellent verbal and written communication skills, well developed organizational skills; reliable, and with great attention to detail.

* Knowledge of medical terminology required;

* Familiarity with components of medical records;

* Basic knowledge of health insurance procedures and regulations especially Medicaid, Medicare and managed care contracts required;

* Computer skills:
Microsoft word, Office and Excel, Computerized Scheduling, mail merge;

* Able to handle multiple tasks and deadlines simultaneously;

* Knowledge of medical terminology, ICD-9 and CPT coding required;

* Ability to partner and work collaboratively with internal departments to meet organizational goals;

* Demonstrated proficiency in Microsoft Office programs;
Electronic Health Record (ECW) preferred.