Referrals CoordinatorColorado State University • Fort Collins, CO
Referrals Coordinator
Colorado State University • Fort Collins, CO
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job_description.job_card.job_descriptionTwo years of specialized medical referrals experience Three years of experience working in a medical office, including any combination of medical records, medical reception, and / or care coordination experience. Experience processing mental and medical health referrals in a multidisciplinary high-volume practice Experience with medical records release procedures Experience performing duties of scheduling, insurance input, and answering healthcare and billing questions Experience with verifying insurance for explanation of benefits and getting authorizations / pre-authorizations Experience as a Medical Assistant, Licensed Practical Nurse, Registered Nurse, or other relevant medical experience Ability to communicate coverage, benefits and answer questions about different insurance carriers specifically the CSU Student Health Insurance Plan. Ability to collaborate with providers and administrative staff Ability to take initiative and work independently Ability to be flexible and adapt to an ever-changing environment Ability to work under pressure and with time constraints Ability to work efficiently in a multidisciplinary healthcare delivering setting Ability to manage and coordinate schedules Ability to use judgment to prioritize workload Excellent interpersonal and customer service skills Excellent listening, verbal and written communication skills Ability to work as a team member and independently Ability to analyze policies, programs, and initiatives to make recommendations for quality improvement Provides assistance with identifying community resources if care needed is outside of CSU Health Network care scope Schedules, problem solves, communicates, and coordinates referral appointments with outside specialists Receives and processes all referral requests from providers, verifying necessary documentation, insurance info, and patient consent. Ensures that the records are sent to the correct address and maintains a log of transactions for releases; refers students to medical records as needed Ensures that all referral forms are sent to health records in a timely manner, after assigned actions are completed Responds to in-house provider questions, requests and concerns regarding the status of patient referrals, care coordination or follow-up status Provides transportation consultation, coordination and support to clinic patients referred to specified health care facilities Assists patients in calling their insurance to get a very clear an idea of what their patient responsibility will be for codes provided by medical providers; utilizes the Cost Estimate Form to document quotes given Provides an up-to-date list of providers in the community that are currently accepting new patients Completes Prior Authorizations in a timely manner for procedures, medications and behavioral health Assists in transitioning graduating students to the community Helps patients understand general insurance concepts Possesses thorough understanding of Kaiser and Tricare for referrals and cost estimates Reviews EOBs and answer billing and bursar questions Answers, responds and documents phone calls, requests and questions from patients in a timely manner; calls must be accurately managed or redirected as appropriate Verifies insurance information for referral purposes and processes insurance information for referral patients Monitors referral timelines to ensure students are seen according to their health concerns and receives appropriate care, escalating any delays as needed Tracks and reports on referral trends common types of referrals, wait times, etc.) to provide feedback for process improvements or to inform decision-making Logs and tracks all referrals using internal tracking tools or EHR systems to monitor progress, status, and follow-up outcomes if needed Ensures all required referral documentation is complete, accurate, and sent to the correct specialist or facility. May help in CSU Health Network outreach efforts by gathering feedback on referral experiences, helping to build relationships with outside specialists, and identifying potential areas for improvement Assists in patient education by providing informational resources about referral processes, specialty care options, or insurance-related questions to help them make informed decisions Maintains confidentiality and professionalism in all patient communications related to referrals and record handling Prepares reports or summaries related to referral activity, patient outcomes, or service utilization, as needed for institutional review or reporting Audits and ensures accuracy of referrals Provide training for staff on referral functions and processes. Helps with onboarding and training new staff on referrals Other duties as assigned by Manager Processes and fulfills records requests in compliance with HIPAA and organizational policies, including requests from patients, external providers, insurance companies, and legal entities Maintains proper documentation of all referrals sent, records requests and releases in accordance with institutional policies and retention requirements Determines the appropriate procedure for release of records over the by phone, email, fax or in person upon request by students Provide assistance and guidance for staff and providers regarding medical records and patient follow-up Ensure the providers have all necessary information for continuity of care. Inform staff what information may be released to protect PHI and support continuity of care Collect encounters, answer check out related questions, review requests for parking citation removal, cash / posting duties, backup for scanning or front desk staff Compile monthly reports Assists in onboarding or training staff on how to request records properly and how to protect PHI during communication Other duties as assigned by Manager
The Referral Coordinator is the primary coordinator of provider-initiated referrals to outside specialties services. The role is logistical and administrative, not clinical. This position must work autonomously and make decisions based on provider requests, and in compliance with CSU Health Networks policies, HIPAA regulations and applicable laws. Duties include :
- Supporting the patient in identifying community providers to support the continuation of their care
- Facilitating records transfer
- Contacting the patient with referral information and / or appointment information
- Tracking communication attempts
- Properly and accurately documenting referral outcomes as appropriate
This position is a full-time, 12-month position, working 40 hours per week, 8 : 00 am 5 : 00 pm, Monday-Friday. The Referrals Coordinator reports directly to the Patient Access and Registration Manager. Required Job Qualifications Education
High School Diploma or GED
Experience
Preferred Job Qualifications Experience
Experience working in PyraMED, CSU Health Networks Electronic Health Record System, or other EHR
Knowledge, Skills, Abilities and Other Characteristics
Essential Duties Job Duty Category Referrals Coordination Duty / Responsibility
Percentage Of Time 70% Job Duty Category Medical Records and Other Administrative Duties Duty / Responsibility
Percentage Of Time 30% Application Details
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