Referral Coordinator

• Manage referral and case activity to ensure timely follow-up and/or hospital response
• Oversee new and open referrals remotely
• Dispatch staff 24 hours a day, 365 days a year
• Assess donor suitability and determine the necessary response using ICU-level medical records, lab values, diagnoses, and medical history
• Collaborate with NEDS team members and hospital partners in Critical Care/ICU settings
• Prioritize and coordinate multiple cases during stressful and changing situations

Referral Resource Coordinator – Critical Care/OPO

• Coordinate, place, and follow up on patient appointments from patients, physician offices, military, attorneys, and workers’ compensation sources
• Answer a multi-line phone system, prioritize calls, and triage cases under pressure
• Obtain and electronically input patient demographics
• Schedule appointments using electronic medical record systems and provide timely follow-up to patients and referral sources
• Maintain working relationships with physician offices to schedule difficult and same-day appointments
• Maintain accurate and organized clerical data while adhering to HIPAA regulations
• Electronically document referrals and track access statistics for monthly reports
• Obtain records for physician review and ensure equitable distribution of referrals to physicians
• Coordinate and schedule multiple appointments for out-of-town patients
• Work with physicians and staff to ensure correct referral protocols are followed
• Assist with operational and managerial support as needed

Referral Triage Coordinator

• Handle the intake process for orders for healthcare services
• Liaise between the company, patients, and health plans
• Verify patient information
• Verify insurance
• Process authorizations and referrals
• Obtain and release clinical documentation
• Respond to health plan inquiries
• Research and resolve patient accounts or escalate them for resolution

• Process internal, incoming, and external referrals for all ambulatory services
• Obtain prior authorizations
• Schedule patients
• Work inbound and outbound phone calls
• Discuss copayment, prepayment, and outstanding balance responsibilities with patients
• Follow and regularly utilize current, standardized referral policies and workflows
• Prioritize referrals by urgency and address them promptly
• Ensure complete demographic, insurance, and pertinent clinical information is sent to referred specialists
• Contact insurance companies to meet prior approval requirements
• Present medical history, diagnosis, prognosis, and other necessary information to insurance companies to establish medical necessity
• Review referral details and expectations with ordering providers and patients

Referral Management Coordinator

• Serve as the primary contact/resource person for patients, primary care physicians, and other healthcare service providers
• Answer and appropriately manage incoming telephone calls
• Verify benefits and services
• Schedule patient appointments
• Respond to patient information needs
• Work on new patient and existing patient referrals
• Verify insurance type and obtain proper authorization as needed
• Contact referring physicians to obtain referral forms
• Obtain additional documents as needed
• Record referrals in the computer
• Ensure new patient charts are complete
• Update co-payments in the computer
• Mail new patient packets
• Assist with front office duties as needed
• Perform other position-related duties as assigned
• Report suspected compliance concerns or violations to a supervisor or Compliance Department

• Verify patient insurance eligibility for procedures and consultations
• Submit and track referral requests through pre-authorization channels
• Follow up weekly on pending referrals and communicate with external providers as needed
• Process and fax incoming/outgoing referral documentation
• Respond to referral-related calls and messages from the call center and clinic schedulers
• Manage email communications across multiple departments and document updates in EMR
• Work closely with team members in scheduling, billing, and the business office
• Participate in monthly bookkeeping meetings
• Provide general backup support to the Business Office
• Answer business office phone lines and assist with other tasks as assigned
• Help ensure timely, authorized care, reduce patient delays, improve provider workflows, and enhance the overall experience of care

• Attend in-services provided by various health plans
• Travel to off-site locations as necessary
• Gather clinical information and process referrals, pre-certifications, pre-determinations, and pre-authorizations according to insurance plan requirements
• Log, track, and review managed care approvals and denials
• Respond to last-minute or emergency referrals, additional procedure codes, and procedural changes for pre-authorizations
• Verify insurance coverage and benefits
• Create price estimates and perform reverifications as needed, including first-of-the-month reverifications for managed Medicaid plans
• Collaborate with insurance companies, providers, and staff to ensure plan requirements are met before patient services are rendered and maximize reimbursement
• Perform other duties as assigned

• Manage patient referrals to specialists, external healthcare providers, and other service providers.
• Process, coordinate, prioritize, and follow up on patient referrals to ensure timely transitions of care.
• Identify referral-process issues and delays and implement solutions.
• Schedule specialist and external-provider appointments based on patient needs, insurance requirements, and provider availability.
• Maintain referral processes and workflows and implement improvements.
• Provide medical records, information, and referral documents to providers promptly.
• Verify insurance coverage and obtain required pre-authorizations.
• Develop relationships with external providers and specialists.
• Communicate referral status, appointment details, preparation instructions, and follow-up actions to patients.
• Address patient inquiries and concerns related to referrals.
• Document referral information in the EMR, including follow-up actions, appointment confirmations, and patient communication.
• Maintain referral records and report referral statuses.
• Ensure compliance with federal and state regulations, including HIPAA.

• Process and track patient referrals
• Communicate with physicians, nurses, and other healthcare staff to obtain necessary patient information
• Ensure all referral paperwork is completed accurately and in a timely manner
• Verify patient insurance coverage for referred services
• Schedule patient appointments with specialist providers
• Answer patient inquiries regarding the referral process
• Maintain updated records of patient referrals and outcomes
• Manage providers' schedules and appointments
• Apply acquired job skills and company policies and procedures to complete standard tasks
• Work on routine assignments requiring basic problem resolution
• Consult with supervisors or senior peers on complex and unusual problems

• Processing and tracking patient referrals
• Communicating with physicians, nurses, and other healthcare staff to obtain necessary patient information
• Ensuring all referral paperwork is completed accurately and in a timely manner
• Verifying patient insurance coverage for the referred services
• Scheduling patient appointments with specialist providers
• Answering patient inquiries regarding the referral process
• Maintaining updated records of patient referrals and outcomes
• Managing providers' schedules and appointments