Summary The Referral Coordinator is responsible for the effective management of all incoming specialist referrals. Duties and Responsibilities • Responsible for coordinating and processing of all patient referrals for specialty services. • Utilizes a high degree of accuracy in obtaining and verifying that all registration data, demographic and insurance information is correct and up to date. • Acts as liaison between Community Medical Group and other healthcare providers while exhibiting and utilizing a high level of customer services skills. • Performs eligibility checks on members as necessary by telephone or electronically as appropriate. • Follows procedures for proper authorization and processing of all referral services including obtaining approval from our medical director. • Supports physicians and patients in synchronizing appointments, authorizations and tests taking place in different clinics. • Sets up appointments and transportation as necessary. • Contacts the patient on a timely basis for all scheduling requirements. • Communicates with patients to ensure follow-through with referrals. • Ensures strict confidentiality of all health records, member information and follows HIPAA guidelines. • Coordinates pre-admission testing requirements with clinic personnel and patients. • Completes all administrative functions related with referral activities in an efficient manner. • Enters all referral, hospital, outpatient and other patient specialty health service authorizations into the computer system following CMG policies and procedures. • Responsible for monitoring all referral reports not received and follow-up in a timely manner. • Performs duties in honest and ethical manner. • Perform other duties as assigned. Qualifications • Education/Experience: • Must have High school diploma or equivalent. • Prior experience in a clinical setting • MS Office programs experience. • Medical Assistant training or certification preferred. • Knowledge of medical terminology and CPT, HCPCS and ICD coding preferred. • Knowledge of Electronic Health Records (EHR) preferred Skills: • Use relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. • Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines and standard accepted practices • Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. • Ability to work with individuals within and outside the organization, in professional and courteous manner. • Must develop constructive and cooperative working relationships with others. • Understand written sentences and paragraphs in work related documents. • Strong ability to use independent judgment and initiative. • Organized and able to manage competing priorities. • Resourcefulness in problem solving. • Actively look for ways to help people. • Strong written and verbal communications skills • Knowledge of medical terminology • Must be extremely detail oriented. • Strong organizational and interpersonal skills. • Knowledge of EHR • Bilingual skills preferred (English/Spanish or English/Creole) • Must develop constructive and cooperative working relationships with others.