Referral Coordinator-Central

SUMMARY

The Referral Coordinator is responsible for following referral procedure guidelines, obtaining prior authorization as needed by health plans, processing referrals and scheduling appointments to specialists for patients per provider requests of Mountain Park Health Center (MPHC).

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

1. All referrals are processed in a timely and efficient manner and according to the referral procedure guidelines. Insurance verification is confirmed prior to processing the referral
2. According to guidelines/primary care provider requests, provides appropriate clinical information to specialists in order for referrals to be processed
3. All STAT and ASAP referrals are processed within one business day. Routine referrals should be processed within 3 business days, routine screening consults within 5 business days
4. Patients are notified verbally and given/sent written confirmation regarding their appointment time, location, special instructions.
5. Maintains referrals tracking system and up to date referrals documentation
6. Follow up on prior authorizations is performed at least weekly and notes made in the referral notes section
7. Statistics of all referrals processed are reported as directed to the Operations Director/manager of the department
8. For referrals not requiring prior authorization, and if patient is at a provider visit, every attempt is made to process the referral(s) while the patient is here
9. Performs other duties as assigned.
10. Must be able to embrace differences among people and able to interact with internal staff as well as external contacts in a culturally competent and respectful manner.

ADDITIONAL RESPONSIBILITIES

• Promotes positive patient/guest relation in accordance with MPHC policies, providing a high level of quality in personal attention and service to patients and visitors.
• Complies with MPHC Safety Policies and Procedures. Ensures compliance with governmental licensing and regulatory requirements where applicable. Conducts annual review of and complete/suggest on-going revisions of the Policies and Procedures specific to his/her department. Maintains familiarity with and abide by all established facility and departmental policies and procedures, noting changes when they are published/posted. Conducts himself/herself in a manner consistent with the Mission Statement and Values of MPHC.
• Observes and respects the confidentiality of information in regard to patients, visitors and co-workers employees including salary information, if exposed to any of the above referenced information in the course of his/her job function.
• Dresses according to MPHCs dress code policy and procedure, as well as, complies with specific departmental regulations pertaining to employee appearance.
• Demonstrates an understanding of facility organizational structure by utilization of appropriate channels of communication. Maintain consistent, timely communication regarding all facets of departmental activities with his/her co-workers, therefore, demonstrating good customer service skills with both external and internal customers.

QUALIFICATIONS

EDUCATION and/or EXPERIENCE

High school diploma or general education degree (GED)

Previous referral experience preferred

LANGUAGE SKILLS

Ability to read and interpret documents such as safety rules, operating and maintenance instructions. And procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups or customers or employees of organization.

MATHEMATICAL SKILLS

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

PHYSICAL DEMANDS

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to walk. The employee much occasionally lifts and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, and ability to adjust focus.

WORK ENVIRONMENT

The noise level in the work environment is usually moderate.

Mountain Park Health Center (MPHC) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to all federal and state law, MPHC prohibits discrimination based on sexual orientation and gender identity. MPHC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.