Specialty Referral Coordinator - Tustin, United States - Families Together of Orange County

Mark Lane

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Mark Lane

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Description

Specialty Referral Coordinator

Position Purpose


The Referral Coordinator holds a pivotal role in overseeing the efficient management of referral submissions and subsequent follow-ups across various insurance payers, encompassing Medicare, Medi-Cal, HMOs, PPOs, and our uninsured patient population.

This position is dedicated to ensuring timely resolution of all assigned referrals, adhering rigorously to internal protocols and contractual health plan requirements.


Core Duties include but are not limited to:

  • Process incoming referral requests from healthcare providers and ensure accurate documentation and completion.
  • Verify patient insurance information and eligibility for referral services.
  • Coordinate with healthcare providers and insurance companies to obtain necessary authorizations for referrals.
  • Communicate with patients regarding referral appointments, instructions, and any required preauthorization paperwork.
  • Maintain detailed records of all referral requests, authorizations, and followup communications.
  • Collaborate with internal departments to schedule referral appointments and coordinate care for patients.
  • Assist patients with any questions or concerns regarding their referral process or appointments.
  • Monitor referral status and follow up on any pending or incomplete authorizations.
  • Ensure compliance with organizational policies, procedures, and regulatory requirements related to referral processes.
  • Provide support and assistance to referral team members as needed.
  • Participate in training sessions to stay updated on changes in referral processes and procedures.
  • Maintain confidentiality of patient information in accordance with HIPAA regulations.
  • Collaborate with other healthcare professionals to facilitate the referral process and ensure seamless patient care.
  • Assist with other administrative tasks and projects as assigned by supervisor or manager.
  • Act as a liaison between patients, healthcare providers, and insurance companies to facilitate smooth referral processes.
  • Communicate effectively with internal and external stakeholders to resolve any issues or concerns related to referrals.
  • Prioritize tasks and manage workload effectively to meet deadlines and ensure timely completion of referral requests.
  • Continuously seek opportunities for process improvement and efficiency in referral workflows.
  • Provide excellent customer service to patients and stakeholders throughout the referral process.
  • Attend meetings and training sessions as required to stay informed about changes in referral policies and procedures.
- _This job description in no way states or implies that these are the only duties to be performed by the employee. He or she will be required to follow any other instructions and to perform other duties, within scope, as assigned by his or her supervisor._


Qualifications, Skills, and Experience:


  • High School Diploma or equivalent (GED) required
  • Minimum 2 years of related experience
  • Bilingual: Spanish required
  • Must excel in multitasking within a highpaced environment.
  • Strong computer skills, acute attention to detail, confident and professional communication, and responsiveness to the needs of both internal and external customers in a personable manner are expected.
  • Knowledgeable in general EMR/EHR systems is preferred.

Salary:
Starting at $22 per hour


Location:
th St. Tustin, CA


  • Families Together of Orange County (FTOC) is proud to be an equal opportunity employer. FTOC does not discriminate based on race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state or federal laws._

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