Position Summary
The Referral Authorization Coordinator is responsible for coordinating specialty care for patients in need of external consultation as requested by the primary care physician. The Referral Coordinator will also be responsible for scheduling, tracking, referral case management and providing reports. The Referral Coordinator will represent the company professionally and positively to enhance and promote the core values and mission, always exercising utmost discretion, diplomacy and tact in customer interactions.
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Major Duties and Responsibilities
- Ensure complete and accurate patient demographics and current insurance information.
- Processes patient referrals to specialty providers by preparing medical charts and records for referral patient visits and providing appropriate clinical information to specialist.
- Obtain authorizations for patient referrals to specialists, diagnostic testing and procedures. Advise physician if authorization request is denied.
- Maintains Insurance authorization for each patient and establishes patients benefits eligibility (not limited to copay, coinsurance, deductible, out of pocket, etc.)
- Maintains patient charts by Chart Prepping daily.
- Maintain ongoing tracking and appropriate documentation on referrals by recording all referrals into EHR.
- Ensure that referrals are addressed in a timely manner, prioritizing urgent items appropriately.
- Assisting with PSR responsibilities
- Other duties as assigned.
