Referral Coordinator Resume Samples

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CA
C Armstrong
Clinton
Armstrong
181 Zion Burgs
San Francisco
CA
+1 (555) 495 2264
181 Zion Burgs
San Francisco
CA
Phone
p +1 (555) 495 2264
Experience Experience
San Francisco, CA
Referral Coordinator
San Francisco, CA
Bahringer, Keeling and Pfannerstill
San Francisco, CA
Referral Coordinator
  • Assists in checking out patients and assists them with referral processing and scheduling process
  • Assists with Performance Improvement activities
  • Facilitate the referrals to contracted provider network and owner hospital facilities
  • Ensures accuracy of information being provided to Management for review
  • Use of a referral data tool to manage and retain care within the Steward network
  • Participates in performance improvement projects
  • Achieves established performance targets
Los Angeles, CA
Referral Coordinator Continucare
Los Angeles, CA
Wunsch-Dach
Los Angeles, CA
Referral Coordinator Continucare
  • Other duties as assigned
  • Partners with Network Development to ensure specialist network is adequate for the geography and escalates accordingly when network adequacy impacts access to care
  • Self-motivated and committed to achieving best results
  • Knowledge of ICD 10 and CPT coding
  • Demonstrate respect for the privacy and confidentiality of patient’s protected health information
  • Proficient with medical terminology
  • Excellent professional communication abilities, at all levels within the organization and with patients, at all times
present
Chicago, IL
Referral Coordinator, Continucare
Chicago, IL
Torphy, Schuppe and Hane
present
Chicago, IL
Referral Coordinator, Continucare
present
  • Establish and maintain relationships with identified service providers
  • Ensure consultation reports are received from the consulting provider to maintain continuity of care
  • Medical Assistant or Professional State Certifications related to healthcare
  • Proficient with medical terminology and familiar with CPT-4 and ICD-9/10 coding
  • Proficient with Microsoft Office applications including Microsoft Word, Excel and Outlook
  • Interpersonal effectiveness (emotional intelligence): Understands oneself, effectively manages emotions, listens and communicates with respect, and builds trusting relationships
  • Process referrals from primary care providers for specialty and ancillary care in a timely manner, prioritizing the referrals according to defined levels of urgency, scheduling member appointments as necessary and communicating referral information to patients
Education Education
Bachelor’s Degree in Initiative
Bachelor’s Degree in Initiative
University of Florida
Bachelor’s Degree in Initiative
Skills Skills
  • Knowledge of basic medical terminology and keyboarding skills. Knowledge of environment of care and infection control policies
  • Ability to work independently; ability to respond effectively under stress
  • Ability to function independently with minimal supervision within the scope of knowledge and authority of the position
  • Detail-oriented with the ability to enter information accurately on paper and into electronic systems
  • Excellent organizational skills and attention to detail
  • Ability to multi- task in a high paced environment with good organizational skills
  • Ability to demonstrate professionalism
  • Excellent time management skills including the ability to multitask and prioritize in a fast paced environment
  • Ability to multi-task, manage details and organize efficiently and effectively
  • Excellent written and oral communication skills with ability to communicate effectively with colleagues at all levels of the organization
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15 Referral Coordinator resume templates

1

Referral Coordinator Resume Examples & Samples

  • Experience in a medical office environment in a role as a referral coordinator or other similar role
  • Previous scheduling experience
  • Knowledge of Medical Terminology, ICD-9 and CPT coding
  • Proficiency in Microsoft Office applications Outlook, Word and Excel
  • Working knowledge of computers, demonstrated technical aptitude, and an ability to quickly learn new systems
  • Organizational skills, ability to prioritize and multi-task
  • Bilingual English and Spanish
  • 1 year with primary care Physician processing outside referrals
2

Referral Coordinator Resume Examples & Samples

  • Generate specialty referrals for members as requested by primary care physicians. This entails prioritizing referrals according to level of urgency, scheduling member appointments as necessary and communicating referral information to members in a timely manner
  • Responsible for assuring that all pertinent medical record documentation is forwarded to the consulting provider as needed
  • Assures that referrals are reviewed by the Medical Director as needed
  • Forwards to the Medical Director any referral requests to non-participating provider-consultants or other special circumstances / requests
  • Responsible for ensuring consult notes are received from the consulting provider as needed
  • Accurately documents medical record system with details about referral and specialist appointments
  • One year of experience in a medical office environment
  • Knowledge of Medical Terminology, ICD-9, and CPT
  • Proficiency in Microsoft Office applications including Outlook, Word and Excel
  • Excellent customer service skills Excellent communication skills, both verbal and written Works well independently and as part of a team
  • Ability to prioritize, strong organizational skills, and multi-tasking abilities
  • Experience with primary care Physician processing outside referrals
  • Bilingual Preferred
  • Experience with EMR
3

Referral Coordinator Resume Examples & Samples

  • Knowledge of basic utilization management concepts and applications in a managed care setting
  • Knowledge of medical terminology, CPT-4 and ICD-9 coding
  • Two years’ experience in a medical office environment in a role as a referral coordinator or other similar role
4

Case Management Referral Coordinator Resume Examples & Samples

  • LPN or RN
  • Ability to be licensed in multiple states without restrictions
  • At least 1 year clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
  • Ability to work independently under general instructions and with a team
  • Health Plan experience
  • Case Manager Certification a plus
  • Previous Medicare/Medicaid Experience a plus
5

Continucare Referral Coordinator Resume Examples & Samples

  • Generate specialty referrals for members as requested by primary care physicians. This entails prioritizing referrals according to level of urgency, scheduling member appointments as necessary and communicating referral information to members
  • Responsible for assuring that all pertinent documentation and x-ray is forwarded to the consulting provider as needed
  • Assures that referrals are reviewed by the Medical Director
  • Forwards to the Administrator any referral requests to non-participating provider-consultants or other special circumstances / requests
  • Develops and maintains excellent record keeping systems
  • Keep Medicare denial log, on a monthly basis
  • Other duties assigned
  • Considerable emphasis on customer service
  • Minimum 1 year experience in a medical office environment in a role as a referral coordinator or other similar role
  • At least 1 year of previous scheduling experience preferred
  • Ability to write reports, business correspondence, and procedure manuals
6

Continucare Referral Coordinator Resume Examples & Samples

  • High School Diploma or GED
  • 1 year of experience in a medical office environment in a patient facing role
  • Proficient speed of typing/excellent command of key-board sufficient to keep-up requirements of very fast-paced environment
  • Proficient with Microsoft Office applications including Word and Outlook
  • Working knowledge of computers with demonstrated technical aptitude and an ability to quickly learn new systems
  • Organizational skills with ability to prioritize and multi-task
  • Experience with Electronic Medical Records/EMR
7

Continucare Referral Coordinator Resume Examples & Samples

  • Experience in a healthcare or medical related customer service role
  • Experience with scheduling appointments and calendaring
  • Knowledge of follow-up plans in a high volume environment
  • Experience with Primary care Physician processing outside referrals
8

Referral Coordinator, CAC Resume Examples & Samples

  • Demonstrate respect for the privacy and confidentiality of patient’s protected health information
  • Proactively identifies, evaluates, and solves problems with logic and a systematic approach; looks beyond the obvious to see root cause issues and creative solutions. Makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints
  • Proficient with medical terminology and familiar with CPT-4 and ICD-9/10 coding
9

Patient Referral Coordinator Resume Examples & Samples

  • A community first, company second culture based on Core Values that really matter
  • Associates or bachelors degree
  • Referral authorization background
  • Experience in the healthcare industry
  • Medical Billing Certificate
10

Referral Coordinator Resume Examples & Samples

  • REnsure accurate and timely processing of prior authorizations and scheduling of radiology procedures
  • Receives incoming requests from physician practices, hospital staff and patients
  • Obtains necessary demographic, diagnostic and insurance information
  • Obtains clinical information required to request prior authorizations. This may be sent by physician practices or obtained directly from the electronic medical record
  • Obtains prior authorizations, as needed, from Health Plans
  • Schedules procedures in MediTech
  • Communicates with physician practices and hospital staff as needed
  • Distributes patient preparation packages
  • Confirms appointments with physician practices, patients and hospital departments as needed
  • Assures that all necessary documentation (Systems as other)
  • Achieves established performance targets
  • Communicates important information to team members
  • Contributes to team efforts to improve workflow and efficiency
  • Provide Outstanding Customer Service
  • Goes the 'extra mile' to assure that customer expectations are met
  • Assists with other projects within the department on an "as needed" basis
  • Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment
  • Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed
  • High school diploma. Associates degree preferred
  • At least 1-3 years experience in healthcare related field. Radiology scheduling/prior authorization experience
  • Knowledge of insurance, prior authorization, medical terminology and ICD 9 coding
  • Demonstrated ability to process prior-authorizations and/or scheduling radiology procedures
  • Knowledge of 3rd party payers
11

Referral Coordinator Resume Examples & Samples

  • Referral Coordinator (Telemarketer 1) will be responsible to speak with prospects via telephoneand email to convert sales
  • Sell packages or book day drives appointments to a prospect listing provided by the company; Owner Referral prospects; Internet Responders; or other prospects from company approved programs
  • Contact leads to confirm scheduled appointments
  • Package and appointment creation to include but not limited to hotel or Wyndham Resorts reservations
  • Provide information about company products and services
  • Educate Owners on established referral criteria
  • Assists in prospect follow-up and support of sales activities
  • Initiate phone calls with prospective leads to confirm appointments for "tours"
  • Invite Owners to referral functions and owner updates (i.e. promotional parties)
  • Enter Owner referrals into the internal marketing database
  • Must meet quotas, measures and requirements established for the Contact Center
  • Contact owners after setting appointments for additional information concerning the referral
  • Maintain accurate records for contacts and call backs in the internal database programs
  • Work with additional departments as necessary to fulfill the mission of the Contact Center
  • Proper adherence to the Values Statement
  • May need to contact leads to reschedule missed appointments or move appointments
  • Assist with other Owner Referral functions, such as promotional parties and seminars
  • Troubleshoot and remedy Owner problems. Refer prospect concern card information and owner concerns to the appropriate department(s). Owner concerns typically include compensation discrepancies, referral payments, and account receivable and reservations issues
  • Evaluate personal performance against meaningful achievement standards
  • Exhibit consistency and persistence through objections
  • Strong cold calling experience
  • Experience in a performance based environment
  • Contact center experience
  • Sales experience
  • Able and willing to employ the power of positive thinking
  • High school or GED equivalent
12

Clinic Lpn Referral Coordinator Resume Examples & Samples

  • Gather, verify and process referrals, authorizations and pre-certifications by working closely with physician(s), patients and payers
  • Communicate details information and answers patients' questions regarding their healthcare plan; provide answers to billing and insurance clarifications questions
  • Coordinate flow of information between medical clinic and referral authorization departments to secure a valid referral for clinic patient
  • Enter referrals, documents communications and action into the system
  • Maintain direct address' to send referrals electronically utilizing the system, as appropriate
  • Develop and maintain database of referral physician offices preferred by each physician within the clinic and utilize website/internet accounts for timely referrals
  • Work requires current license or certification in one of the following roles: RN, LPN
  • Two years experience in clinic/physician office
  • CPR Certification (obtained within 6 months of start date)
13

Referral Coordinator Resume Examples & Samples

  • Facilitates orders outside to outside facilities
  • Coordinate scheduling of office visits for the referred patient
  • Logs in daily to system to check status of patient not mapped correctly and updates patient charts
  • Set up referring providers, payers and chart mergers in the Electronic System
  • Knowledge of documentation required for physician appointments
14

Referral Coordinator Resume Examples & Samples

  • Under direct and indirect supervision, analyzes and processes referral requests for CCS to assure they meet established program criteria. Receives and interprets referral requests, determines benefits and communicates this information to members, non-plan providers, NWP providers and other internal staff as appropriate. Coordinates communications from contracted and non-contracted vendors related to the admission of KP members. Contacts patients regarding receipt of referral and provide brief explanation of CCS programs, verify demographics and benefit information, and facilitates patient agreement to receive services from designated programs. Processes non-clinical aspects of referrals to CCS including, insurance coverage, physician verification of NPI and PECOS, hospice attending physician, case assign clinicians, coordinates start of care date within each program's regulatory requirements. Effectively maintains daily accurate records of referrals to ensure patients are admitted to services in a timely manner. Serves as a liaison between referring and program physicians, patients/families, department supervisors, managers, and CCS staff to ensure timely patient care. Identifies and assists with timely transitions across programs
  • Under direct and indirect supervision, processes non-clinical aspects of referrals for CCS, Salem, Longview, and when programs are at capacity or require referral outsourcing. Provides initial authorization when patients are outsourced. Establish spot contracts when patients are outsourced to a non-core agency/facility. Communicate effectively to ensure that patients referred out to outside agencies get care timely. Provide patient information when requested by outsourced agencies
  • Minimum three (3) years demonstrated Medicare regulation experience pertaining to home care and facility care
  • Minimum one (1) year of demonstrated insurance and benefit plan experience
  • Minimum three (3) years of processing referrals in home care or facility care
  • Thorough knowledge of KP organization and structure
  • Thorough knowledge of continuous process improvement principles, tools, and practices
  • Working knowledge of KP computer systems including Healthconnect, common membership, and Tapestry
15

Referral Coordinator Resume Examples & Samples

  • Possess professional telecommunication skills to effectively articulate benefit information, clinical and financial needs, and/or challenges to patients, referral sources, insurance carrier representatives and internal teams in order to facilitate the referral process and obtain complete information required to initiate a patient's start of care
  • Supports and adheres to HIPAA guidelines and Pentec Health policies and procedures with respect to patient privacy practices and standards of care
  • A general understanding of the various insurance plans and benefits for the different payor classes (State Medicaid, Commercial insurance and Medicare Part D plans) and being able to effectively communicate the therapy(s) and coverage requirements to the Patient and Payor sources
  • Apply prior and current knowledge of insurance carrier requirements and authorization practices to capture and communicate appropriate clinical and financial data required to obtain approval/authorization of service, professionally documenting the detailed outcome of this process in CPR+
  • Provide Supervisor/Manager with feedback and suggestions for improving the process, bringing immediate attention to any areas preventing achievement of goals and objectives
  • Contact new patients, review the new patient on-boarding process, answer any questions, and serve as an additional ongoing contact for patient with inquiries regarding reimbursement
  • Communicate well with internal and external customers in order to efficiently and effectively bring a patient from referral through start of care
  • Ensure timely follow-up and accurate notation of progress made on follow-up of all required paperwork in a concise manner
  • Maintains accurate records and keeps current all documentation to streamline reporting functions and ensure adequate information is available in support of positive cash flow and collection efforts
  • Serve as a support for reimbursement and collections
  • Performs all other duties assigned by their respective Supervisor
  • General knowledge of computer operating systems using electronic medical records, Microsoft Excel and Word skills
  • Detail oriented, highly organized, and personable
  • Have strong communication and customer service skills
  • Be empathetic, a good listener and be able to 'diffuse' a situation if a customer is upset
  • Problem solver, be resourceful, and possess the ability to professionally articulate finding and recommendations
  • Strong organizational and process skills
  • Strong computer skills and the ability to utilize various software packages (once trained)
  • Ability to execute directives toward established goals
  • Ability to work well with all staff levels
  • Ability to meet deadlines and work well under pressure while maintaining attention to details and a positive outlook
  • Takes initiative, persists at tasks and pursues completion of objectives
  • Grasps new concepts, approaches and systems
  • Hands on learner who can pick up new systems and also learn in a side by side work environment
  • Ability to deal with ambiguity- most situations are unique and require the person to research the provider site for answers
  • Shares information with others to help them perform their jobs & seeks information from others
  • Able to persuade others by using a variety of interpersonal techniques and approaches to help others understand therapies provided
  • Able to switch to different strategy methodologies when one is unsuccessful
  • Practices attentive and active listening
  • Expresses oneself clearly in conversation and interaction with others
  • Identifies information needed to clarify a situation and seeks that information from appropriate sources
  • Builds trust and credibility by demonstrating consistency between words and actions
  • Takes significant action to develop skills needed for effectiveness in current or future job
  • 2-3 years recent experience in a related field such as intake and customer service
  • General knowledge of insurance verification and authorization
  • General knowledge and use of Electronic Medical Record and documentation
16

Referral Coordinator Resume Examples & Samples

  • Assigns appropriate CPT procedure and HCPCS codes following coding guidelines for all referral requests and to ensure appropriate ICD-9 codes have been entered on all requests
  • Provides assistance to TSPMG providers and office staff on coding and targeted review questions
  • Maintains current knowledge of both coding and targeted review to ensure that the right requests are initiated and sent to review and that proper coding is done on all requests so as to meet all regulatory guidelines and audit standards which will result in proper reimbursement. Responsible for the day to day referral coordination activities as noted below
  • Complete and accurate data entry for all external referrals into Epic Tapestry based on policy and procedures
  • Determines eligibility and benefits regarding each referral/authorization and coordinates with membership accounting and customer service
  • Determines appropriate consultant per specialty type and per contract and benefit guidelines and acts appropriately to time frame specified by Permanente physician or consultant (re: routine, expedite, stat)
  • Provides assistance for members by scheduling appointments for external referral consultations, outpatient tests and procedures with our contracted vendors
  • Provides information to the member regarding location of consultant's office, phone number and the need to bring the referral and clinical information to the consultant's office
  • Once data entry is complete, a copy of the referral form is sent to the consultant via the member or fax
  • Assists and educates members by answering questions regarding referral and authorization process
  • Assists and educates the external consultants with questions and concerns with the referral process in the medical office
  • Maintains effective interaction/communication with physicians and their staff as necessary to gather information for referrals as needed
  • Assists the Referral Coordinator Supervisor with running and preparing reports as requested
  • Remains knowledgeable of contract benefits and current, relevant state and Federal regulations
  • Builds effective working relationships with physicians/staff, QRM staff, and other departments within the health plan
  • Identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Referral Coordinator Supervisor
  • Identifies the need for social service intervention and refers the member to Kaiser Permanent's social workers as appropriate
  • Maintains member confidentiality
  • Knowledgeable and compliant with regional personnel policies and procedures
  • Knowledgeable and compliant with QRM departmental and unit specific policies and procedures
  • Participates in annual regional and departmental compliance training
  • Knowledgeable and compliant with Principles of Responsibility
  • Develops and maintains an awareness of how to report compliance issues and concerns
  • One (1) year of minimum experience and working knowledge of CPT , ICD-9 coding required
  • Two (2) years of experience in a medical setting, at least one of which should be in managed health care delivery
  • Two (2) years of data entry experience
  • Experience with and understanding of benefits and non-benefits
  • Coding, precertification back ground preferred
17

Referral Coordinator Resume Examples & Samples

  • Takes new patient phone calls and obtains new patient demographic and insurance information. Determines availability of records per protocol
  • Establishes system of ongoing referrals. Reviews daily physician schedules and evaluates need for referrals. Schedules new patient appointment according to physician template
  • Verifies patient eligibility and insurance benefits related to the treatment of cancer or hematological disorders. Obtains referral authorizations and documents into database
  • Assists in financial counseling of patient, including drug replacement program information and other assistance to the patient
18

Referral Coordinator Resume Examples & Samples

  • Excellent customer service and problem solving skills
  • Ability to handle fast paced/stressful situations in a calm and professional manner
  • Previous computer experience required
  • Medical terminology and CPT/ICD-9 coding required
  • Demonstrate initiative and ability to work independently
  • Demonstrate good organizational skills and attention to detail/accuracy
  • Previous experience working in a fast paced physician practice preferred
  • Minimum of two (2) years experience with computer registration/scheduling system required
  • Minimum of two (2) years experience in medical office setting required
  • Prior knowledge working/dealing with HMO’s and third party payor insurance required
19

Receptionist / Referral Coordinator Resume Examples & Samples

  • Works closely with Medical Records, Billing, and Financial Counselors to ensure therapy visits are covered
  • Meets the communication needs of the patient/family, departmental staff and medical staff
  • Implements directions from the physicians and rehab staff
  • Provides cross coverage and for administrative support duties in PT, OT, Speech, EEG, EMG and Sleep Lab
  • One year experience in office setting or hospital setting preferred
  • Experience with billing and insurance preferred
20

Associate Patient Referral Coordinator Resume Examples & Samples

  • Contacts insurance companies to ensure prior approval requirements are met. Present necessary medical information
  • Maintains ongoing tracking and appropriate documentation on referrals
  • Review details and expectations about the referral with patients
  • Assist patients in problem solving potential issues related to authorizations and referrals
  • High School diploma / GED
  • Experience with referrals
21

Regional Referral Coordinator Resume Examples & Samples

  • 3-5 years previous experience in a hospital, physician office or case management setting required
  • Previous experience in working with database systems and telephone call center required
  • 3-5 years p revious insurance experience required
  • Proficient knowledge of community resources, Sutter Health resources, third party payers ( i.e., PPO, HMO, and Medicare Risk insurance plans) is required
  • Working in-depth knowledge of managed care requirements and processes is required
  • Working knowledge of all state Medicare and Medi-Cal guidelines and process is highly preferred
  • Knowledge of ICD-9 and CPT Coding preferred
  • Knowledge of patient registration process highly preferred
  • PC proficiency in word processing and database software applications required
  • Effectively interacts with individuals from all levels of the organization
  • Medical and managed care terminology required
  • Ability to organize and work independently with minimal direction in a fast paced environment required
  • Proficient understanding of patient flows, processes and advanced medical and technical terminology and practices required
  • Thorough understanding of disease process, anatomy, and physiology as necessary to assess referral requests and appropriate level/provider of care required
  • Ability to communicate effectively, oral and written, with individuals possessing varying levels of comprehension required
22

Referral Coordinator Resume Examples & Samples

  • 1 year or more of hands-on healthcare experience in a clinical setting, preferably within the Medicare population Proficient with medical terminology
  • Bilingual in English and Spanish-fluent levels in both
  • If selected for this role, AHCA screening and compliance will be required
  • Familiarity with CPT-4 and/or ICD-9/10 coding
  • Referrals experience in a hospital, clinic, or office environment
23

Referral Coordinator Resume Examples & Samples

  • Follows protocols for proper authorization and processing of all referrals
  • Assists team in educating patient/family, follows JSA standing orders/protocols, assists patients with external resources when needed
  • Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to JSA policy and procedure
  • Responsible for monitoring all referral reports not received and timely follow-up in accordance with JSA policy and procedure
24

Receptionist / Referral Coordinator Resume Examples & Samples

  • Possess excellent communication and organizational skills with the ability to multi task in a high pace environment with good organizational skills, set priorities, and meet deadlines
  • Ability to communicate effectively with patients and all levels of personnel in a professional, courteous and effective manner using excellent customer service skills
  • Ability to read, write, speak and understand the English language fluently
  • Ability to travel locally may be required
25

Referral Coordinator, Continucare Perrine Resume Examples & Samples

  • Process referrals from primary care providers for specialty and ancillary care in a timely manner, prioritizing the referrals according to defined levels of urgency, scheduling member appointments as necessary and communicating referral information to patients
  • Collect information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to reviewing clinicians and specialists. Present necessary medical information such as history, diagnosis and prognosis
  • Knowledge of a medical terminology
  • 2 years or more of hands-on healthcare experience in a clinical setting preferably within the Medicare population
  • Knowledge of ICD 9/10 and CPT
26

Referral Coordinator Resume Examples & Samples

  • A healing focus
  • A selfless heart
  • A tireless resolve
  • Minimum of 1 year experience in medical field - service delivery (referrals, claims, insurance, billing, etc.)
  • Experience with Worker's Compensation preferred
  • Excellent written and oral communication skills with ability to communicate effectively with colleagues at all levels of the organization
  • Must display proper business etiquette and be skilled in the arts of diplomacy and tact
  • Excellent time management skills including the ability to multitask and prioritize in a fast paced environment
  • Exemplary decision making and problem solving skills
  • Ability to build and maintain productive business relationships
27

Referral Coordinator Resume Examples & Samples

  • Assigns new and re-start referrals, order changes and insurance changes to Benefit Verification Team members based on payor, geographic area and contracts
  • Tracks assignments from initiation to completion, following up as appropriate to ensure timely processing
  • Communicates continuously with Reimbursement Management regarding the status of referrals to aid in timely clearance
  • Demonstrates ability to work effectively and maintain expected productivity
  • Ensures accuracy of information being provided to Management for review
  • Schedules own time based on priorities
  • Demonstrates a high degree of personal responsibility regarding accuracy and quality of work
  • Demonstrates effective communication skills with patients, family members, other staff members and outside organizations or persons
  • Detailed
  • Ability to work well with various personalities and within a team
28

Referral Coordinator Continucare Tamarac Resume Examples & Samples

  • Partners with Network Development to ensure specialist network is adequate for the geography and escalates accordingly when network adequacy impacts access to care
  • Bilingual English/Spanish (fluent levels in both)
  • Proficient computer skills with the ability to adapt to and learn new systems quickly
  • 2 years or more of hands-on healthcare experience in a clinical setting, preferably within the Medicare population
  • Medical Assistant or Professional State Certifications related to healthcare
29

Referral Coordinator Supevisor Resume Examples & Samples

  • Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the
  • Ensure timely processing of patient referrals for the practices in the market
  • Acts as a resource to the physician practices by providing hands on training and education to the staff and physicians as needed
  • As the supervisor, will ensure timely pre-authorization process; coordination of office visit scheduling; facilitation of order to outside
  • Provides direction and guidance to staff members, ensuring all work is completed in a timely manner
  • Makes recommendations for process improvement as needed, assists with staff scheduling and responds to staff needs as required
  • Knowledge of ICD-9, ICD - 10 and CPT codes
  • Skill in establishing and maintaining effective working relationships with employees, policy-making bodies, third-party payers, patients,
30

Referral Coordinator Resume Examples & Samples

  • Process referrals from primary care providers for specialty and ancillary care in a timely manner, prioritize the referrals according to defined levels of urgency, schedule member appointments as necessary and communicate referral information to patients
  • Partner with Network Development to ensure specialist network is adequate for the geography and escalates accordingly when network adequacy impacts access to care
  • Proficient computer skills with the ability to adapt and learn new systems quickly
  • Coder, Medical Assistant or Professional State Certifications related to healthcare
  • Fluent bilingual - English and Spanish
31

Referral Coordinator Resume Examples & Samples

  • Answering office phones, making appointments, confirming appointments and rescheduling when necessary
  • Distributes information to patients regarding office policies, procedures, information about the practice, etc
  • Knowledge of third party payers regulations and requirements
  • Knowledge of ICD-9 and ICD – 10 CPT codes
32

Referral Coordinator Resume Examples & Samples

  • 3-5 years experience is preferred
  • Serve as liaison between members of specific health plans and primary care providers and specialists, to coordinate referrals and help members and providers navigate the Steward provider network
  • Triage service requests
  • Create and process referrals
  • Use of a referral data tool to manage and retain care within the Steward network
  • Assist consumers with PCP and specialist selection
  • Schedule PCP and specialist appointments
  • Under the direction of the Practice Manager, follows office protocol for processing out of network
  • Ensure accurate and timely processing of all requests
  • Receives incoming requests from physician practices and consumers
  • Verifies eligibility and coverage
  • Obtains insurance referrals
  • Assists with PCP selection
  • Schedules patient appointments by contacting physician practices or scheduling directly in Athena
  • Communicates with physician practices and patients as needed
  • Confirms appointments and/or referrals with physician practices and consumers
  • Assures that all necessary documentation occurs in a timely manner
  • Meets established quality expectations e.g. confidentiality, accuracy, customer service and professionalism
  • Provides back up to medical secretaries as needed including answering the phones
  • Attends office staff meetings
  • Provide Outstanding Customer Service to ensure that customer expectations are met
  • Ability to meet deadlines in high-pressure environment
  • Demonstrates effective interpersonal skills in intense situations
  • Knowledge of managed care concepts and medical terminology
  • Ability to multi task and work with multiple software applications
  • Knowledge of insurance, medical office practice and/or referral processing
  • Demonstrated ability to process insurance referrals and/or schedule physician appointments
  • Demonstrated understanding of the need for patient confidentiality in a HIPAA compliant environment
  • Self motivated
  • Demonstrated ability to work independently and as part of a team
  • Associates degree or equivalent amount of education and experience; Bachelor's degree preferred
  • At least 1-3 years experience in healthcare related field. Medical office experience strongly preferred
  • Experience with NEHE, Emdeon, and Medical Scheduling Software
  • Fluency in a foreign language desirable e.g. Spanish, Russian, Portuguese, Haitian Creole and Vietnamese
33

Patient Referral Coordinator Resume Examples & Samples

  • Collects clinic specific medical records needed for all specialty clinic appointments. Fax release of information requests on patient behalf to assist patients with collecting medical records. Scan medical records to the EMR after sorting by external record type (i.e. external lab, external office notes) so that they are readily available anywhere on campus
  • Sends out clinic specific new patient packets once appointment is scheduled. Collects program specific questionnaires and applications (i.e. transplant application, liquid diet program and breast questionnaires)
  • Answers questions regarding specialty programs and clinics on campus to potential patients, mails pamphlets and other informational marketing materials to patients. Promotes UT Southwestern services to callers
  • Enter patient, clinic and marketing information calls into provided software to allow for analysis by marketing and senior leadership
  • Duties performed may include one or more of the following core functions: (a) Directly interacting with or caring for patients; (b) Directly interacting with or caring for human-subjects research participants; (c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or (d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records
34

PRN Referral Coordinator Resume Examples & Samples

  • Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner
  • Process patient referrals for the practices in the market
  • Assist patient with finding resources that accept the various insurances
  • Calls insurance companies to get medications approved that may have been denied due to formulary changes
  • Knowledge of insurance verification process
  • Knowledge of specific Insurances such as Medicare and Tricare Prime
35

Referral Coordinator Resume Examples & Samples

  • Gather and document a detailed and comprehensive understanding of the various insurance plans and benefits for the different payor classes (State Medicaid, Commercial insurance and Medicare Part D plans) and being able to effectively communicate the therapy(s) and coverage requirements to the Patient and Payor sources
  • Maintains accurate records and keeps current all Progress Notes to streamline reporting functions and ensure adequate information is available in support of positive cash flow and collection efforts
  • Assists with Performance Improvement activities
  • Knowledge of home infusion therapy and the criteria requirements imposed by the various insurance plans
  • Demonstrated computer hardware, peripheral, CPR+ and Microsoft Excel and Word skills
  • Problem solver, be resourceful, and possess the ability to professional articulate finding and recommendations
  • Persuades people from various levels, positions or backgrounds by using a variety of interpersonal techniques and approaches (Insurance providers cannot pay claims without full documentation. Our reps need to come at the problem from multiple angles to find a way to get the claim/referral processed
  • Switches to different strategy when an initially selected one is unsuccessful
  • 3- 5 years recent experience in a related field such as intake and customer service of high tech home infusion therapies, durable medical equipment or health insurance background required
36

Referral Coordinator, Continucare Resume Examples & Samples

  • Proficient with medical terminology
  • Excellent professional communication abilities, at all levels within the organization and with patients, at all times
  • Active FL LPN license in good standing
37

Referral Coordinator Continucare Resume Examples & Samples

  • Establish and maintain relationships with identified service providers
  • Ensure consultation reports are received from the consulting provider to maintain continuity of care
  • Excellent communication skills. Ensures understanding regardless of the communication vehicle; understands the needs and perspectives of others and tailors delivery accordingly; shares information appropriately; actively listens
38

Referral Coordinator Resume Examples & Samples

  • 6 months customer service experience
  • 6 months contact center experience
  • 6 months sales experience
39

Administrative & Referral Coordinator Resume Examples & Samples

  • 3 Prospectively identify patients who require authorization for specialty care and obtains appropriate provider approval prior to the appointment date. Effectively communicates alternatives to patient if service is denied
  • 4 Generates audit reports from the Caretracker registration and appointment scheduling system to monitor, troubleshoots inefficiencies in the referral authorization process. Recommends interventions to and work with practice manager to resolve
  • 6 Serve as a resource for clinical and administrative staff regarding managed care guidelines and affiliated managed care plans
  • 8 Prepares and reviews automated registration and appointment scheduling reports on billing edits, registration quality, patient no shows, etc. Initiates and implements corrective action as necessary
  • 9 Monitors patient flow and patient satisfaction. Prospectively identify potential issues. Trouble-shoot issues and work with Practice Manager to develop and implement systems to enhance efficiency
40

Referral Coordinator Resume Examples & Samples

  • Serve as liaison between SHMG and SH ED to coordinate patient care and treatment
  • Coordinate care between ED, healthcare providers, Case managers and Social Work
  • Maintains ongoing tracking and appropriate documentation of referrals in eClinicalWorks to promote medical team awareness and patient-centered care
  • Ensures complete and accurate registration, including patient demographic and current insurance information
  • Assembles information concerning patient's clinical background and referral needs
  • Where necessary, conducts pre-authorizations for referrals
  • Reviews details and expectations about the referral with patients
  • Schedules referral visits in a timely manner and informs patient of scheduled appointments in person or via phone
  • Ensures that referrals are addressed in a timely manner and conducts appropriate follow-up on all open referrals
  • Demonstrates ongoing commitment to customer service excellence and supports the customer service plan. Practices and adheres to Stamford Health’s “Code of Conduct” philosophy, SHMG’s Standards for Service Excellence and organizational values of: Teamwork, Integrity, Compassion, Respect and Accountability
  • High School Diploma or equivalent with a minimum of three years of related medical office experience required
  • Demonstrated strong interpersonal, organizational skills
  • Ability to function independently with minimal supervision within the scope of knowledge and authority of the position
  • Solid phone/customer service skills
  • Knowledge of office equipment operation (SHMG and SH electronic health record, telephone system, fax machine, copy machine, etc.)
  • Careful attention to detail
  • Ability to work both in a team and independently
41

Referral Coordinator Resume Examples & Samples

  • Education in coding and medical terminology, or equivalent experience
  • Minimum one year in clinic setting or medical billing office within the last three years
  • Background in computer data input utilizing EPIC, Word and/or Access
  • Ability to concentrate and pay close attention to detail
  • Ability to self-manage, set priorities and operate with minimal direct supervision
  • Ability to develop and maintain effective working relationships with peers, physicians and other staff members
  • Medical billing experience
42

Referral Coordinator Resume Examples & Samples

  • Functions as liaison between patients, referring physicians (or their representatives) and MGH/MGPO departments to initiate and coordinate the registration, scheduling and follow-up aspects of the referral process. As a primary interviewer of patients, asks medical and financial questions to determine the direction of a referral
  • Documents all patient demographic, medical, financial and referral information into the computer in strict compliance with established department procedures for the purpose of getting a hospital registration number and scheduling of an appointment
  • Manages the appointment schedules for those physician offices which have reserved dates and times for the referral service; confirms appointments with both the patient and the department; follows up with the patients and the physician offices to determine and document appointment disposition and communicates with referring providers regarding the status of patient referrals
  • Requires an in-depth knowledge of the referral triage processes and office policies of every department at MGH; responsible for knowledge of insurance stipulations that may affect appointment scheduling
  • Facilitates Physician Gateway registration for outside referring providers
  • Responsible for the completeness and accuracy of transcribing referral information in multiple systems
  • Keeps manager informed of issues, especially as they relate to the interaction of the service with other areas of the hospital
  • Responsible for some operational needs of the office, including but not limited to ordering supplies; assist in training new employees and volunteers
  • High School Diploma, some college preferred
  • Prior customer service experience preferably in a contact/call center environment
  • Prior healthcare experience
  • Strong communication, interpersonal and team skills
  • Ability to exercise judgment in dealing with sensitive, confidential information
  • Detail-oriented with the ability to enter information accurately on paper and into electronic systems
43

Referral Coordinator Resume Examples & Samples

  • Research and process incoming referral requests received via fax or system generated
  • Check HP eligibility and benefits as needed
  • Gather clinical notes and HP criteria as needed
  • Scan and attach faxed clinical information
  • Demonstrate good problem solving skills
  • Provide a high standard of customer service for Patients, Physicians and Staff
  • Demonstrates professional and courteous communication skills. Supports a collaborative and cooperative environment when working with others in order to facilitate mutual respect and effective interpersonal relations
  • Meet all department standards
  • Responsible for running daily reports to capture all work stream referrals including; urgent/emergent referrals, ASA referrals, portal referrals and indemnity/PPO submissions
  • Assist providers, patients, other departments regarding issues related to referrals
  • Responsible for the coordination of PCC meetings, by preparing agenda, roster, distribution of reports, food orders, scheduling guests, scheduling and meeting room preparation
  • Ability to follow company policies, procedures and directives
  • Ability to prioritize, multitask with attention to detail and timeliness for task completion
  • Perform any additional duties that may not be inclusive in job description as requested by Management team that is within the scope of knowledge or ability of the Referral Coordinator
  • Travel may be required to meet business needs
  • This team member will be an assist retro review nurse and denials coordinator
  • Experience in Managed Care or Medical Field 1-2 years preferred. Should have the ability to read and interpret health plan benefit manuals and CPT/ICD coding
  • Type with speed and accuracy, 40 - 50 wpm
  • Must have excellent computer skills
  • Excellent customer service skills and be a team player
  • Must be dependable
  • High degree of organizational skills
44

Referral Coordinator Resume Examples & Samples

  • Referral and Discharge -Actively engages and educates potential customers to the benefits and appropriateness of hospice care. Processes inquiries for all new referrals (internal and external). Performs assessment of potential patients consistent with Hospice of Cleveland Clinic policies, procedures, and admission criteria in conjunction with patient’s physician. Provides patient/family education, including arrangements of family meetings as necessary, to ensure adequate knowledge and understanding of the hospice benefit. Coordinates hospice services required for discharge to include ordering of medications, supplies and DME, hand-off communication with field team and documentation in the electronic medical record to ensure seamless transition from hospital to community setting. Flexibility in setting and revising priorities for one’s daily assignment based on patient needs/acuity, family requests and available resources
  • Admissions/General In Patient/Symptom Management admissions -Performs admission assessments for new admissions into the CCHS hospitals and documents information in the electronic medical record within specified time frame. Performs daily assessment and coordinates plan of care with hospital/in-patient staff for General Inpatients (GIP). Uses verbal and written communication to ensure continuity of care
  • Marketing and Customer Service -Assertively campaigns for the value and benefit of Cleveland Clinic Hospice by promoting the utilization of its services to patients, families, hospital/facility staff, community resources and agencies. Maintain comprehensive working knowledge of contractual relationships and ensure that patients are admitted according to contract provisions. Collaborates with manager to develop and utilize creative marketing opportunities to increase referral base
  • Minimum four years of varied work experience as a professional nurse including one year in an acute setting
  • Marketing experience preferred, preferably in healthcare
45

Counseling Intake & Referral Coordinator Resume Examples & Samples

  • Conducts and completes student intake assessments and assigns them to Center staff members based on student need. Educates students on Counseling Center services and refers them to other professionals or resources as appropriate
  • Provides telephone and in-person triage, crisis evaluation, and crisis management for students seeking mental health services to assist in the prioritization, scheduling, and assignment of new clients
  • Facilitates and coordinates with University entities and community on referrals to and from Counseling Services
  • Represents Counseling Services at events by hosting a table, providing brief informational presentations about Counseling Service to groups, and providing stress management presentation to student classes under supervision of outreach coordinator
  • Attends staff meetings and supervision meetings as necessary
46

Referral Coordinator Resume Examples & Samples

  • 1 year or more of hands-on healthcare experience in a clinical setting
  • If selected for this role, you will be required to complete and pass background check/investigation for AHCA compliance
  • Knowledge of ICD and CPT medical coding
  • Desired bilingual Creole/English
47

Referral Coordinator Resume Examples & Samples

  • Describe your background and qualifications and why you believe you would be a good fit for this position at the West Ann Arbor Health Center – Parkland Plaza
  • Outline your service excellence skills and experiences which would be applicable to this position
  • In your most recent position, how was service excellence emphasized?
  • Describe a situation in which a customer or colleague was upset and the steps you took to resolve the issue to a reasonable conclusion
  • Clerical experience is necessary, preferably in a medical setting
  • Must have knowledge of front end systems (MiChart, Cadence, Web Denis, NaviNet, M-Connect, and other online insurance referral systems) and front end processes, including ICD and CPT coding
  • Experience and knowledge of patient insurances, managed care concepts and referrals
  • Individual must exhibit a professional and positive image when interacting with patients, faculty and staff
  • Must adhere to a high standard of personal and professional conduct; possess excellent customer service, interpersonal, and communication skills; and demonstrated ability to interact with a diverse population
  • Candidates must be able to work effectively with a multidisciplinary team, handling multiple responsibilities in a fast-paced environment
  • Must demonstrate problem solving skills, proficient computer and keyboarding skills, and excellent attendance
  • Prior experience performing complex scheduling
  • Familiarity obtaining medical records or professional medical billing
  • Financial counseling experience for healthcare patients
  • Exceptional interpersonal skills, and the ability to work well within a team
  • Demonstrated active listening, written, verbal, and information technology skills
  • Experience within an ambulatory setting
48

Referral Coordinator Resume Examples & Samples

  • 1 year experience in a receptionist role in the medical field is a must
  • 1 year experience in verifying benefits is a must
  • Proficient in Word and Excel
  • High School Degree is a must
  • Team player attitude, energetic, with a focus on excellent customer service
49

Referral Coordinator Resume Examples & Samples

  • 2 years of experience in a hospital, healthcare business office or registration environment preferred
  • Working knowledge of insurance referral and pre-authorization requirements and the clinical referral process
  • Excellent interpersonal skills required to communicate with different groups of employees and agencies
  • Must possess strong time management skills. Work efficiently and organizes time appropriately. Must have the ability to prioritize daily work assignments
  • High level of analytical ability in order to and interpret information from various sources
  • Working knowledge of Windows based software (including word processing, database and spreadsheet)
  • Ability to learn and utilize referral tracking systems, EHRs, and other relevant programs
  • Follow HHCMG and Federal Regulation to ensure compliance with HIPAA, Medicare notifications and documentation, and compliance with the Patient Bill of Rights
50

Referral Coordinator Resume Examples & Samples

  • Uses, protects, and discloses DaVita Medical Group patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to Company policy and procedure
  • Responsible for monitoring all referral reports not received and timely follow-up in accordance with Company policy and procedure
  • Ability to travel may be required
  • Previous experience with EMR systems is a plus
51

Outgoing Referral Coordinator Resume Examples & Samples

  • Receive and place all outgoing referrals to our partner broker networks
  • Organize and maintain referral fee agreements with various brokers
  • Maintain data input into the Leading Real Estate Companies of the World system and profit power
  • Coordinate and assist with outgoing referral fee payments that are received
  • Assist Hanna Relocation Associates with outgoing and interoffice referrals
  • Various other responsibilities as assigned
  • Strong computer/internet proficiency, must be able to navigate multiple web sites and be familiar with map quest
  • Must possess strong organizational, communication, teamwork, client service, and problem-solving skills
  • Must work effectively in a fast paced environment
  • Ability to prioritize and re-prioritize as situations and needs change throughout the workday
  • Develops and maintains a positive and professional working relationship with all members of the team, customers, clients and service partners
  • Adheres to all company policies and procedures as outlined in the employee manual
  • Proven, successful track record
  • Real Estate License (active or escrowed)
  • Working knowledge of the relocation process
52

Rehab Referral Coordinator Resume Examples & Samples

  • Graduate from a school of nursing, physical therapy, occupational therapy, speech therapy, masters in social work, or medical school
  • At least one year of experience in case management/discharge planning/utilization review in a health care setting. BLS required
  • GA Licensed Registered Nurse or Licensed Practical Nurse with registered nurse oversight, PT, OT, ST, MSW or M.D
53

Referral Coordinator Resume Examples & Samples

  • Identifying patients' needs prior to and during transport
  • Facilitates effective transition of patients between referring and receiving institutions
  • Works effectively with the multidisciplinary team for correct patient placement
  • Consistently gives thorough reports which accurately reflect patient status to other team members
  • Utilizes available resources within and outside the institution for the purpose of providing comprehensive transport
  • Incorporates feedback from team members into improvements in operations which support patient transport
  • Keeps current with regard to the following certifications: Basic Cardiac Life Support (BCLS) and annual JCAHO competencies
  • Coordinates communication between medical staff
  • Communicates regularly with medical and nursing staff to address any special needs of the unit required for patient care
  • Maintains documentation of department activities, regularly, for reporting purposes and for modification and improvement of department operations
  • Compiles productivity reports, including individual employee and departmental production
  • Reviews call tapes with Director for quality of communication
  • EMT certification required
  • Current Maryland in good standing as an EMT
  • Basic Life Support – Health Care Provider
  • 3 - 5 years experience as an EMT or LPN
54

Referral Coordinator Resume Examples & Samples

  • 3 – 4 years of experience
  • Experience working within a large, complex heath care setting
  • Familiarity with UMHS electronic medical records systems
55

Patient Referral Coordinator Resume Examples & Samples

  • Communicates with the patient on a timely basis for all scheduling requirements
  • Coordinates pre-admission testing requirements with clinic personnel and patient
  • Receives consultant reports, maintains documentation, and routes to the appropriate physician promptly
  • Knowledge of medical coding a plus
56

Authorization / Referral Coordinator Resume Examples & Samples

  • Supports the preparation for audits and data requests
  • Assists with manual data entry
  • Maintains schedules by coordinating with appropriate parties
57

Referral Coordinator Resume Examples & Samples

  • 2 years of experience working in medical environment or with medical insurances
  • Knowledge of insurance billing and managed care
  • Data processing skills, such as word processing
  • Excellent verbal communication and interpersonal skills
  • The ability to learn new processes/procedures
  • 4 or more years of experience
58

Referral Coordinator Resume Examples & Samples

  • NEOGOV/Government Jobs on-line or paper application
  • Supplemental questionnaire responses
  • Skilled in using computer including proficiency in a Windows environment, and the ability to use drop down menus, point and click software, multiple screens and the ability to enter data
  • Skilled in attention to detail
  • Ability to use word-processing and spreadsheet software to complete assigned tasks
  • Ability to communicate in a pleasant, non-judgmental, respectful, culturally sensitive manner under varying levels of stress (this may include high levels of noise, limited resources, etc.)
  • Skilled in using office machines such as fax machines, copiers, label maker, and printers
  • Ability to gain functional knowledge of medical terminology, ICD-coding, CPT coding and other managed care requirements
  • Knowledge of Washington State health care guidelines and procedures
  • Skilled in working independently; working in a team setting; and using independent judgement
  • Skilled in handling difficult interpersonal interactions with discretion and diplomacy
  • Skilled in prioritizing and completing multiple tasks simultaneously
  • Ability to work with interpreters and clients for whom English is a second language
  • Knowledge of state health care programs
59

Referral Coordinator / Procedure Scheduler Resume Examples & Samples

  • Requires a high school certificate or equivalency
  • Prefer experience with Electronic Health Record system and handling patient benefits
  • 1-2 years management experience
60

Referral Coordinator Unc Eye Carolina Crossing Resume Examples & Samples

  • Processing referrals
  • Patient registration
  • Patient scheduling
  • Documentation scanning
  • Insurance eligibility
61

Referral Coordinator Resume Examples & Samples

  • Arranges referrals as indicated by the provider, utilizing proper insurance referral guidelines and CPT, ICD9 and HCPCS coding. May be required to send necessary lab and ancillary reports
  • Verifies insurance information, current PCP, and medical necessity for the referral. Obtains authorization for release of medical records
  • Obtains insurance pre-certification and authorization as required by the various insurance plans. Notifies the ordering provider of any conflict or delay in scheduling
  • May schedule testing, make necessary appointments, document in the patient's chart and notify the patient of the appointment and necessary special instructions
  • Pulls and retrieves files as required. Routes charts back to dictation area or file as indicated
  • Answers telephones, routes messages and redirects as necessary
  • Maintains referral log and verifies that patient completed appointment; verifies receipt of specialists consult notes and/or follows up with specialist if needed
  • Follows the CHRISTUS Physician Group guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
  • Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the CHRISTUS Mission
  • Maintains established CHRISTUS Physician Group policies, procedures, objectives, quality assurance, safety, environmental and infection control
  • Implements job responsibilities in a manner that is consistent with the CHRISTUS Mission and Code of Ethics and supportive of CHRISTUS Physician Group's cultural diversity objectives
  • Supports and adheres to CPG Service Guarantee
62

Referral Coordinator Resume Examples & Samples

  • Obtains authorization for procedures on both non-HMO as well as HMO/managed care patients. Under the direction of the CMS department is responsible for gathering additional clinical information needed to support medical necessity of requested HMO/managed care service
  • Prepares clinical data for attachment for Chief of Staff, CMS Dept., or CBO approval. Forwards clinical data to the specialists/consultants as required
  • Participates in documentation and forms preparation as needed for California’s Child Health and Disability Prevention Program (CHDP)
  • Attends committee meetings as required and brings/communicates required information to the physicians and medical office administrator
  • Proper telephone etiquette
  • Ability to read, understand, and follow oral and written instruction
  • Ability to sort and file by alphabet or terminal digit
  • Experience: One year experience with medical terminology, coding and medical charting
  • MA certification
63

Referral Coordinator Resume Examples & Samples

  • Attends Referral training class and various referral system training classes within 1st month of employment
  • Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting
  • Process referrals for services requested by Providers within established guidelines, to include external referrals
  • Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes
  • Processes requests for additional referrals/authorizations when requested by providers
  • Assures referrals are maintained within appropriate network or payer requirement
  • Provides a standard of excellence as it relates to customer service and satisfaction for all customers
  • Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure
  • Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources
  • Documents required information into the appropriate systems
  • Maintains patient privacy
  • Knowledge of insurance plans and guidelines
  • Ability to obtain authorizations and pre-certifications from insurance plans
  • Ability to communicate effectively, both written and orally
  • Above average organizational skills
64

Referral Coordinator Resume Examples & Samples

  • Participates in performance improvement projects
  • Participates as an active care team member in the coordination of patient care
  • 2 years experience in the field or in a related area
65

Referral Coordinator Resume Examples & Samples

  • High school Graduate / GED
  • Must have excellent reading, writing and communication skills
  • Must have knowledge of health plan requirements for referral of patients
  • Typing and computer knowledge preferred
66

Referral Coordinator Resume Examples & Samples

  • Assemble information concerning patient’s clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialists
  • Communicates with clinical staff any issues or any need of further follow up
  • Ensure that referrals are addressed in a timely manner
  • Performs other related duties as indicted or when requested by supervisor
  • 1+ years of Medical Office Experience
  • Proficient computer skills-Word / Outlook
67

Referral Coordinator Resume Examples & Samples

  • Three years administrative experience in health care preferably performing referral, admissions or registration activities
  • Knowledge of the operation of a personal computer and data entry for entry and retrieval of demographic and financial information. Ability to operate routine office equipment
  • Demonstrated ability to listen to patient information and translate it to written documentation. Ability to listen to patient complaints and resolve them using positive, proficient guest relations skills. Ability to use resourcefulness and problem-solving skills in appropriately resolving various patient pre-admission issues
  • Ability to work independently; ability to respond effectively under stress
  • Highly effective communication skills are required to relate to multiple levels of clinical and administrative personnel and to advise patients and visitors about hospital policies and procedures. Effective written communication skills are also required in completing admission and other documents properly
  • Demonstrates courtesy and open communications with patients and referral sources. Ability to observes and apply relevant hospital and departmental policies and procedures. Observes and promotes positive guest relations
  • Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient’s requirements relative to his or her population-specific and age specific needs
68

Referral Coordinator Resume Examples & Samples

  • Initiates and manages all components of clinical referrals for various services
  • Sets up appointments and any special arrangements such as transportation, interpreter services, etc
  • Verifies insurance coverage and obtains authorizations, if needed, from insurance providers
  • Acts as liaison between hospitals, physicians, health plans, vendors and patients or referral sources
  • Coordinates flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient
  • Develops and maintains database of referral physician offices preferred by each physician within the clinic
  • Assists Practice Manager with complaint resolution and solutions related to patient referrals
  • Enters referrals, documents, communications and actions in system
69

Referral Coordinator Resume Examples & Samples

  • Ability to communicate effectively orally and in writing and express ideas clearly
  • Ability to clinically evaluate patients for appropriate rehab placement
  • Skilled in problem solving
  • Ability to maintain effective working relationships with fellow employees, patients, families, insurance providers and physicians
70

Referral Coordinator Resume Examples & Samples

  • 3 years Relevant experience (customer service, patient registration, appointment scheduling)
  • Must have computer skills and dexterity required for data entry and retrieval of required job information
  • Must be proficient with Windows-style applications, keyboard, and various software packages specific to role
  • Proficiency with Microsoft Office Suite (Word, Excel, Access, etc.)
  • Strong interpersonal skills with ability to effectively and courteously communicate with a diverse group of internal and external calls
  • Good judgment skills to handle difficult situations
  • Good organization and time mangement skills
  • Knowledge of Epic system (registration and scheduling)
71

Referral Coordinator Resume Examples & Samples

  • Six (6) months experience in a medical office/practice setting handling insurance verifications, authorizations and referrals
  • High school diploma, GED or equivalent experience
  • Working knowledge of computers and scanners
  • Excellent interpersonal skills and professional communication
  • Ability to work independently and direct own work within stated productivity standards