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Referral Coordinator

UConn Health - Community Network
USA
Full-time
Mid · 3+ years experience
Onsite
Discovered 3 days ago

Full Job Posting

Qualifications

  • High school diploma or GED.
  • A minimum of three years of medical records and/or clerical experience in an outpatient medical setting.
  • Ability to work collaboratively with patients, medical staff, co-workers and the public and ability to work independently and as part of a team.
  • Exceptional phone and customer service skills; strong verbal and written communication, interpersonal, organizational, time management, and multi-tasking skills.
  • Ability to organize and prioritize work as required and to work with a high attention to detail and accuracy
  • Working knowledge of EHR and registration/billing software desired.
  • An understanding of insurance providers, their portals and their expectations for authorization approvals preferred.

Responsibilities

  • Monitors Electronic Health Record (EHR) tasks throughout the day to capture referral requests in real time.
  • Verifies insurance information and performs eligibility checks by telephone or electronically, as appropriate, for referral purposes.
  • Obtains authorizations for patient referrals to specialists, diagnostic testing, and surgeries
  • Gathers pertinent information as needed via EHR or from clinical team to accurately complete pre-authorization/referral process.
  • Prepares and accurately processes referral and pre-authorization paperwork; ensures that referrals are addressed in a timely manner, prioritizing urgent items appropriately.
  • Produces and submits all appropriate notification letters for patients and clinicians, as required.
  • Ensures complete tracking and follow-up on all referral requests and specialty report requests.
  • Answers, responds and documents phone calls, requests and questions from patients in a timely manner; reviews details and expectations about referrals with patients.
  • Responds to clinical support staff questions, requests and concerns regarding the status of patient referrals, care coordination or follow-up status.
  • Utilizes third party payer/insurance portals as needed.
  • Schedules referral appointments directly on behalf of patients, as needed.
  • Properly follow-up with provider and patient regarding denials to referral requests.
  • Maintains confidentiality of PHI by following all applicable Health Insurance Portability and Accountability Act (HIPAA) regulations.
  • Performs other related duties as required

Preferred Qualifications

  • Working knowledge of EHR and registration/billing software desired.
  • An understanding of insurance providers, their portals and their expectations for authorization approvals preferred.

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