Referral Coordinator

Company: Memorial Care
Location: Fountain Valley
Posted on: June 1, 2021

Job Description:

Purpose Statement / Position Summary Creates and assists with the preparation of referral requests. As part of the preparation process will verify eligibility, benefits, request any needed clinical notes and accurately complete or forward referral to appropriate staff to finalize decision. Ensures that all referral policies and procedures are followed as required to meet all contractual, regulatory and federal requirementsEssential Functions and Responsibilities of the Job Research and process incoming referral requests and CRM's received via fax or system generated Check HP eligibility and benefits as needed Gather clinical notes and HP criteria as needed Scan and attach faxed clinical information Demonstrate good problem-solving skills Provide a high standard of customer service for Patients, Physicians and Staff Demonstrate professional and courteous communication skills. Supports a collaborative and cooperative environment when working with others to facilitate mutual respect and effective interpersonal relations. Meet all department standards Responsible for running daily reports to capture all work stream referrals including; urgent referrals, ASA referrals, portal referrals and indemnity/PPO submissions, ODAG reports and other requested ad hoc reports for utilization, productivity and operational metrics. Assist providers, patients, other departments regarding issues related to referrals Responsible for the coordination of PCC meetings, by preparing agenda, roster, distribution of reports, food orders, scheduling guests, scheduling meeting times and room preparation if work location is at clinic site. Ability to be at work on time Ability to follow company policies, procedures and directives Ability to interact in a positive and constructive manner Ability to prioritize and multitask with attention to detail and timeliness for task completion. Perform any additional duties that may not be inclusive in job description as requested by Management team that is within the scope of knowledge or ability of the Referral Coordinator. Telecommuting (full or part time) may be an option and is based on business necessity, functional area, productivity measures and availability of resources. Able to travel to other clinics to cover staffing needs and training. Experience Experience in Managed Care or Medical Field 1-2 years preferred. Familiarity with the interpretation of health plan benefit manuals and CPT/ICD coding, preferred. Type with speed and accuracy, 40 - 50 wpm. Must have excellent computer skills. Excellent customer service skills and be a team player. Must be dependable. High degree of organizational skills. Education Must be a High School Graduate/ or G.E.D or equivalent. Medical terminology, preferred.

Keywords: Memorial Care, Fountain Valley , Referral Coordinator, Other , Fountain Valley, California