Referral Coordinator

Role Scope: 

The Referral Coordinator position is responsible for accurate and timely data entry of referral requests into the appropriate portal.  They are also responsible for follow-up on all specialty referrals and coordination of care for urgent referrals.  The referral coordinator is an integral part of the care team, working as a liaison between the patient, providers, utilization management and various departments to ensure timely access to specialty care. 

Core Responsibilities & Expectations for the Role 

• Contribute to a center experience that Participants want to spend time in, a team culture that cares and creates joy, and an environment where all participants and team members belong. 

• Continue to raise the bar.  Constructively seek and share feedback, and help us implement changes in order to improve clinical outcomes and experience for participants. 

• Exhibit and honor Habitat’s values. 

• Receive, review, and process referral requests from healthcare providers. 

• Coordinate with specialists, hospitals, and other healthcare providers to schedule patient appointments. 

• Ensure all referral information is accurate, complete, and compliant with healthcare regulations. 

• Serve as a primary point of contact for patients, providers, and insurance companies regarding referral status. 

• Provide patients with information on referral processes, appointment details, and any required pre-appointment preparations. 

• Maintain effective communication with healthcare providers to ensure timely updates on referral statuses. 

• Verify and update patient records in the electronic health record (EHR) system. 

• Ensure all referral documentation, including medical records and insurance authorizations, is accurately maintained. 

• Prepare and submit reports on referral activities and outcomes. 

• Verify insurance coverage and obtain necessary authorizations for referred services. 

• Work with insurance companies to resolve any issues related to coverage or authorization. 

• Assist patients with understanding their insurance benefits related to referrals. 

• Ensure compliance with all relevant healthcare regulations, including HIPAA. 

• Maintain patient confidentiality at all times and ensure that all patient information is handled in a secure and confidential manner. 

• Visit outside healthcare offices for relationship-building purposes, as needed. 

• Performs related duties as assigned. 

Required Qualifications:  

• High school diploma or GED required. 

• Minimum of 2 years of experience. 

• Strong organizational and multitasking abilities. 

• Excellent communication and interpersonal skills. 

• Proficiency in using EHR systems and other healthcare-related software. 

• Knowledge of medical terminology, insurance processes, and healthcare regulations.