Referral Center Coordinator I - EngageMED Corporate

Job Description

Job Description

Description :

I. Job Summary / Job Purpose

The Referral Center Coordinator I works with patients and clinics requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

II. Key Responsibilities

• Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.
• Monitor and maintain designated referral queue in an organized and efficient manner
• Set up appointments and coordinate clinic visits
• Coordinate flow of information between referring medical clinic and specialist office to secure a valid referral for clinic patient.
• Enter referrals, documents communications and action into the system, as appropriate.
• Notify physician(s) and patient when referral is denied, or if additional information is needed.
• Develop and maintain database of referral physician offices preferred by each physician within the system.
• Consult referring practice with complaint resolution and solutions related to patient referrals.
• Perform other duties as assigned by the coordination center manager or director.
• Maintain performance and quality standards based on established call center metrics including turn-around times
• Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction

III. EngageMED Core Expectations

At EngageMED, we expect all our employees to live the values of Reverence, Integrity, Compassion and Excellence at work by :

IV. Core Job Competencies

Core EngageMED Behaviors : The following behaviors have been identified as critical to all staff roles at EngageMED :

Role-Specific Behaviors : these additional behaviors are necessary in the role :

Skills, Knowledge or Abilities critical to this role :

Qualifications

V. Job Requirements / Qualifications

a. Education / Accreditation / Licensure (required & preferred) :

b. Experience (required and preferred) :

VI. Disclaimers

Requirements :