Referral Coordinator (40 hours/week)
M-F hours vary between 730-5
POSITION SUMMARY: The Referral Coordinator is responsible for coordinating specialty care and testing for patients in need of external consultations and diagnostic imaging as requested by the Primary Care Physician. This includes but is not limited to obtaining authorizations from insurance and scheduling with External Providers. Ensures compliance with hospital policies, billing guidelines, and payer policies.
HOURS: Hours will vary Monday-Friday 7:30am-5pm
ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:
- Serves as first-line resource for all customers (internal/external) with regards to referrals. Must have a basic understanding of the referral process.
- Completes 2 of the following Job Functions:
Obtain insurance referrals & authorizations for diagnostic testing and procedures; communicate with referrring physicians for peer to peer and denials follow up. Will be required to maintain a working knowledge of Insurance verification and authorization.
Process patient referrals to specialty providers by preparing medical records and providing appropriate clinical information to the specialist. Communicating appointment information and expectations with patients in a timely manner. Complete outreach to obtain consult notes for completed appointments.
Working knowledge of diagnostic imaging scheduling, cancelling and rescheduling process in EPIC. Completes outreach to patients and schedules imaging appointments in EPIC; reviews details and expecatations with the patients for their upcoming appointments. Provide follow up phone calls once consult appointments have been scheduled to notify patients of appointments; as well as outreach to obtain consult notes for completed appointments
- Maintain appropriate and accurate documentation.
- Adheres to team standards and work flows
- Attempts to understand patients needs and offers guidance and resolution of issues through collaboration with team members and outside departments.
- Demonstrates excellent “over the phone” patient relations skills, e.g. smiles, cheerfully greets patients, and engages all patients in a genuine, warm, and caring manner.
- Maintains regular consistent attendance, personal appearance, punctuality, and adherence to applicable health and safety procedures.
SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:
- Identifies work processes that can be improved upon, eliminated, or handled through electronic processes and escalates to leadership.
- Basic knowledge of Family Medicine Practices, purpose and operations.
- Basic medical terminology.
- Knowledge of various insurance plans such as Medicaid, Medicare and Commercial insurances.
- Ability to work efficiently and comfortably with all levels of staff.
- Performs other related duties as assigned.
MINIMUM REQUIRED QUALIFICATIONS:
- High school diploma or certificate
- One (1) year experience in a healthcare setting
- One (1) year experience in customer service related field
- One (1) year of using medical terminology
- One (1) year experience in medical referral/insurance
Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely.
PENN MEDICINE LANCASTER GENERAL HEALTH offers the following benefits to employees:
- 100% Tuition Assistance at The Pennsylvania College of Health Sciences
- Paid Time Off and Paid Holidays
- Shift, Weekend and On-Call Differentials
- Health, Dental and Vision Coverage
- Short-Term and Long-Term Disability
- Retirement Savings Account with Company Matching
- Child Care Subsidies
- Onsite Gym and Fitness Classes
Posted on 09/15/2023
PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.
Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.