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Referrals Coordinator

Phoenix, AZ · Healthcare

Prior Authorization / Referral Coordinator - Medical Clinic Group
Central Phoenix, AZ!

THIS IS AN IN-OFFICE POSITION - Located in downtown Phoenix.

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.

ESSENTIAL DUTIES AND RESPONSIBILITIES include:

  • 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 According to guidelines/primary care provider requests, provides appropriate clinical information to specialists in order for referrals to be processed
  • 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
  • Patients are notified verbally and given/sent written confirmation regarding their appointment time, location, special instructions.
  • Maintains referrals tracking system and up to date referrals documentation
  • Follow up on prior authorizations is performed at least weekly and notes made in the referral notes section Statistics of all referrals processed are reported as directed to the Operations Director/manager of the department
  • 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
  • Performs other duties as assigned. 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.

QUALIFICATIONS EDUCATION and/or EXPERIENCE

  • High school diploma or general education degree (GED) Previous referral experience preferred
  • Prior experience as a Front Office Receptionist or Front OfficeMedical Assistant in a clinical setting with experience performing prior authorizations and/or referrals.
  • 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.

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Steve Thornley | 480.863.5913
steve@staffclinix.com | web: staffclinix.com
STAFFCLINIX - Get your people™
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