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Job Title: Referral Coordinator

GENERAL SUMMARY:

A medical office position responsible for managing all referrals for the medical offices in the market.

EDUCATION:

High school diploma/GED required; completion of a medical assisting or medical office assistant program preferred.

EXPERIENCE:

Must have a minimum of four years of experience working in a medical office setting.

OTHER REQUIREMENTS:

None
Performance Requirements:Knowledge:
1. Knowledge of the insurance verification process.
2. Familiarity with specific insurances such as Medicare and Tricare Prime.
3. Understanding of documentation required for physician appointments.
4. Proficiency in Electronic Health Systems.
5. Knowledge of ICD-9, ICD-10, and CPT codes.
6. Awareness of clinic policies and procedures to provide effective patient care.

SKILLS:

1. Strong multi-tasking abilities.
2. Excellent customer service skills.
   Novant Health is an equal opportunity employer and conducts all human resource practices in compliance with federal, state and local civil rights and employment legislation. Accordingly, Novant Health considers all applicants for employment equally, without regard to race, color, religion, sex, national origin, age, disability, veteran’s status, marital status, sexual orientation, gender identity or expression and provides them with an opportunity to progress in the organization consistent with their skills and interests

1. Adhere to and support the mission, purpose, philosophy, objectives, policies, and procedures of Novant Health.
2. Comply with HIPAA regulations and maintain confidentiality in accordance with privacy standards.
3. Demonstrate support for corporate compliance by being knowledgeable of compliance responsibilities, adhering to federal and state laws, regulations, and corporate policies that affect job functions, and reporting compliance issues in a timely manner.
4. Process patient referrals for practices in the market.
5. Facilitate orders to outside facilities.
6. Coordinate scheduling of office visits for referred patients.
7. Assist patients in finding resources that accept various insurances.
8. Obtain pre-authorization from payers.
9. Contact insurance companies to secure approvals for medications that may have been denied due to formulary changes.
10. Log in daily to the system to check the status of patients not correctly mapped and update patient charts.
11. Set up referring providers, payers, and chart mergers in the electronic system.
12. Perform additional responsibilities as needed.