Referral Coordinator

• Properly maintains and tracks referrals from beginning to end, including specialty and diagnostic referrals
• Answers, responds to and documents phone calls, requests and questions from patients, physicians, ancillary services and specialty offices
• Assembles patients’ clinical background and referral information and provides documented clinical information to specialists
• Reviews referral details and expectations with patients
• Communicates preparation instructions to patients via documented orders or protocol
• Receives and reviews referral requests and prioritizes orders based on urgency
• Schedules, problem solves, communicates and coordinates referral appointments with patients, physicians, specialists and central scheduling
• Collaborates with physicians, mid-level providers, LPNs and MAs
• Maintains patient confidentiality and follows HIPPA guidelines
• Obtains necessary authorization for referrals and diagnostic testing
• Collaborates with the Billing Analyst on denied claims involving missing prior authorization or referrals in the EMR system
• Maintains knowledge of referral and payer prior authorization requirements, eligibility guidelines and documentation requirements
• Communicates insurance decisions to patients
• Conducts follow-up calls with physician offices, patients and payers to complete pre-certification
• Confirms payer network status with specialists and coordinates alternate arrangements when necessary
• Acts as the referral-related point of contact and subject matter expert for assigned offices

Explore Referral Coordinator at Trinity Health. Review requirements and application details.