Full job description
Referral Coordinator / Admin Person for WC/EPS
Job Description
The Referral Coordinator is responsible for referral operations, establishing and standardizing systems and procedures for the distribution and use of health information throughout the organization, coordinating and referral functions with all other departments. The Referral Coordinator works with individuals within the organization as well as outside of the organization to coordinate important health related specialist visits for the patient and is expected to be meticulous in managing and tracking such information.
The Job also entails a Business Development Role. You will reach out to existing customers/Employers and build a relationship to grow business.
Essential Duties and Responsibilities
1. Ensures current referral policies and workflows are standardized, accurate and up to date.
2. Prioritizes and tracks referrals by their urgency and addresses them in a timely manner.
3. Participates in the selection, orientation and training of referral personnel.
4. Ensures complete demographic, insurance information and appropriate/pertaining clinical information is sent to referred specialists.
5. Contacts insurance companies to ensure prior approval requirements are met. Presents necessary medical information such as, history, diagnosis and prognosis to insurance companies if deemed necessary to prove medical necessity of services.
6. Reviews details and expectations about the referral with both ordering providers and patients. Requests new referrals to be ordered when applicable.
7. Develops and implements systems as required by EMR functionality and/or regulatory agencies.
8. Identifies and utilizes community resources; establishes relationships with servicing providers and personnel.
9. Point of contact for patients and specialists for any questions or rising concerns. Assist in problem solving potential issues related to their referral due to language or social barriers. If unable to help, assist in finding the right point of contact to further help.
10. Other functions as directed by the Supervisor.
11. Work with Employers and sell company services for Pre and Post Employment. Including Workers Compensation offered by the company.
12. Occ Med billing understanding and follow up needed
Qualifications
- Experience with referrals in healthcare preferred
- Experience with Electronic Health Records required
- Proficient knowledge of insurance policies. CPT and ICD-10 knowledge.
- Computer literate and proficient in MS Office.
- Excellent critical thinking and decision-making skills.
- Strong customer service skills, professional attitude, clerical expertise, IT competence, and strong organizational skills.
- WC / OCCMED experience. Urgent Care experience.
Weekly day range:
PS: It’s All About You!
American Family Care has pioneered the concept of convenient, patient-centric healthcare. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine. Ranked by Inc. magazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient.
If you are looking for an opportunity where you can make a difference in the lives of others, join us on our mission. We invite you to grow with us and experience for yourself the satisfying and fulfilling work that the healthcare industry provides.
Please note that a position may be for a company-owned or franchise location. Each franchise-owned and operated location recruits, hires, trains, and manages their own employees, sets their own employment policies and procedures, and provides compensation and benefits determined by that franchise owner. Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more.
We are an Equal Opportunity Employer.