Referrals Coordinator

Overview

Responsible for supporting medical providers by coordinating specialty referrals for patients of CBHA.

Referral Coordinator salary range: $21.19 - $25.43 with ability to go higher for highly experienced candidates.

Responsibilities

Referral Processing

• Ensures specialty referrals submitted by providers meet patient eligibility This includes all out-patient referrals submitted by Medical, Dental, Eye Care, and Behavioral Health providers
• Processes all incoming referrals within 24 hours of receipt and following the Referral Policy when handling Routine, Urgent, and STAT referrals.
• Composes and mails patient pertinent appointment
• Submits prior authorizations through patient
• Processing all external referrals sent to CBHA for all services lines
• Process all internal referrals placed by CBHA providers to achieve optimal patient outcomes. This includes contacting patient and scheduling appointment
• Provides scheduling assistance to patients if

Responsible for the Referral Cycle

• Responsible for referrals tracking to completion, including out-patient, internal, and external referrals.
• Maintains ongoing tracking of scheduled
• Reviews the monthly referral activity
• Assist in the development and implementation of tracking

Responsible for developing specialty provider

• Serves as liaison between CBHA and Wellpoint, as well as other carriers and insurers.
• Maintains excellent customer service relations with specialty providers and
• Tracks and reviews the monthly utilization of specialty referrals.

Responsible for promoting applicable insurance

• Promotes insurance
• Handles confidential patient

Promotes a positive work culture and upholds clinic policies and procedures, including the WE CARE standards of

 

Must uphold confidentiality at all times in regards to CBHA activities, reports, financials, patient health information and other proprietary information specific to CBHA.

Qualifications

Professional and Technical Requirements:

• Possesses a basic level of written and verbal communications skills, computational and computer skills and mathematical knowledge typically acquired through completion of a high school
• Possesses knowledge and training in referral coordination in a healthcare setting, at the equivalent of an Associate’s degree or trade school
• Possesses familiarity with the processes and operations performed by the referrals department, sufficient to understand the importance of various forms, schedules, documents and processes.

 

Technical Skills:

• Ability to prepare basic correspondence and simple reports in Microsoft
• Ability to use Microsoft Excel to create tables and simple displays of
• Ability to create basic presentations in Microsoft
• Ability to use clerical and numerical skills in preparing final drafts and documents from raw data.