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Referral and Care Coordinator

Primary Purpose

Coordinates non-clinical referral process for outpatient visits. In collaboration with the nurse navigator and PFS, serves as a liaison for referring providers, patients/families, physicians, nurses, and other core members of the interdisciplinary teams and department; ensures appropriate access for new and transitioning patients into the practice.

MINIMUM SPECIFICATIONS

Education

High School Diploma or equivalent.

Experience

Must have two (2) years of medical office or business office experience, including one year of referral and/or registration management experience.

Skills or Special Abilities

and other medical information, such as, but not limited to,

Responsibilities

Receives and reviews all clinical referrals for appropriateness based on established criteria, conferring with appropriate clinical staff for circumstances outside of the given scheduling pathways for clinical management. Ensures referral is assigned to the patient's appointment/account. Facilitates required work-ups and places SDO for labs, as required for specialty services for new patients.

Consults with Patient Finance Services for financial counseling to ensure assignment of the proper financial classification for reimbursement enhancement, as needed.

Notifies clinic/procedure area, nurse navigator, and/or patients to inform them of the authorization denials. Obtains additional clinical information for denials and resubmits to the plan for further consideration.

Collaborates with physicians/fellows and nurses to determine scheduling priorities for access related to overbooks/reschedules. Assures coordination of appointments to facilitate rapid diagnosis and treatment within established timelines.

Uses electronic medical record to schedule appointments, to verify/update patient information, and to document appropriate communications. Provides interdepartmental communication to ensure accurate information and coordinate appointments.

Communicates with internal and external physicians' offices to manage referrals, and other medical information, such as but not limited to: clinical notes, slides, scans/films, and pathology

Referral and Care Coordinator

Job Description

Qualifications

Responsibilities

Benefits