Referral Coordinator

POSITION SUMMARY:

The Referral Coordinator provides administrative support for patients, support staff, and clinicians in the practice setting r/t referrals, authorizations and scheduling concerns. The Referral Coordinator serves as the initial point of contact for external physicians, physician representatives, and the public at large, as well as being responsible for assuring all critical information is relayed for the patients our physicians refer for Specialty Services with outside providers.The incumbent must possess exceptional public relation/customer service skills and be able to communicate with patients and physicians in an effective manner. Primary responsibilities are to identify the needs of the patient and execute a plan to meet the needs for registration, scheduling, insurance compliance, My Chart support, and general questions. In addition, the Referral Coordinator must also be able to assist in resolving issues and improving quality of care, Support PSR activities and learning needs, to ensure necessary authorizations are obtained prior to patient visits, check-in and check-out patients, update patient demographics, and to troubleshoot any billing problems that may arise. Specific Referral Coordination responsibilities are listed below.

JOB DUTIES AND RESPONSIBILITIES:

• Service Standards: Demonstrated ability to remain professional, even when working through difficult situations, support the vision of the practice and the core values of UCSF Benioff Children’s Physicians.

• Essential Functions:

• Referral Coordinator Responsibilities: Responsible for executing the process and workflow surrounding internal/outgoing specialty referrals for MFM patients. Specific Referral Coordination responsibilities include and are not limited to:

• Coordinates the process of referring patient to appropriate clinics

• Obtains authorizations as needed per specialty and insurance requirement

• Explores insurance inconsistencies as they arise to assist Reg/Sched processes

• Coordinates outgoing referrals and scheduling with destination specialty coordinators

• Communicates with patient to insure follow through with referrals

• Confirms any testing ordered in conjunction with specialty services requested, is accounted for in ordering and communication workflow

• Under direction of Clinical Services Manager and Nurse Practitioner, participates in coordination of complex MFM patients into the UCSF Benioff Fetal Medicine Program.

• Assist in coordinating and providing learning needs of PSR and MA teams, specific to referrals and authorizations

• Serves as front line for triage of referral and authorization queries

• Support identifying and structuring workflow improvements, and staff education/support

• Responsible for directing self-Payment paperwork to Rev Cycle; reassigns if will be on PTO.

• Support Clinical Services Manager in monitoring Workques, and identifying areas of needed support and learning

• PSR related Functionality – Productivity/Efficiency (Serves as back-up in PSR role PRN)

  • .Answers phones professionally and warmly to assist all callers with their healthcare objectives.
  • Receives patients at the care center. Tasks include: providing information about clinical services, insurance and payment policies; patient’s registration; processing new patient paperwork; collecting copays; and following up with patients for payment /insurance information when necessary.
  • Schedules and confirms appointments. Monitors schedule frequently for capacity.
  • Attends to billing corrections in a timely fashion. Asks for assistance as needed to expedite patient concerns as quickly as possible.
  • Through Epic/Right-Fax, distributes incoming paperwork, lab results, and scans records into patient chart on a daily basis.
  • Helps maintain office supplies, equipment and general office systems.
  • Attends to physician and practitioner needs to support patient care and practice development.

• Technical Skills

• Effectively utilizes Electronic Health Record (E.H.R.), Microsoft outlook and MS Office Suite.

• Takes a proactive view of daily and weekly clinician schedules, fills openings via the waiting lists and through requesting patient names from clinicians. Works diligently to keep clinicians’ schedules full.

• Keeps patient demographics and insurance information accurate and up-to-date in in the EHR.

• Communication

• Provides friendly, knowledgeable and responsive internal and external customer service. Sets appropriate expectations for patient and staff like.

• Reminds patients of their appointments 72 hours in advance and on a daily basis or as needed, defined by the department workflow.

• Checks Right Fax throughout the day and returns patient calls the same day and no later than 24-hours.

• Utilizes EHR to communicate about appointment details. Keeps other administrative team members well-informed of any patient(s) or physicians(s) needs, schedule changes, etc.

• Keeps Supervisor informed of customer compliments, complaints, or problems / critical issues with clinical services in a timely manner.

• Quality

• Maintains current knowledge of all physicians and services of the practice.

• Consistently extends a professional, warm environment by using a pleasant tone of voice and maintaining composure at all times, using acquired AIDET skills.

• Attends staff meetings and other office meetings, as required.

• Holds self and peers accountable to uphold the Standards of Behavior regardless of race, ethnicity, culture, religious affiliation, disability, socioeconomic background, education, sexual orientation, marital status, gender, age or position.

• UBCP Citizenship

• Adheres to all UCSF Benioff Children’s Physicians policies and procedures (i.e. Administrative and Human Resources), practices safe work habits, and engages in good business standards and practices.

• Respects and is sensitive to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, teamwork, and demonstrates respect for others.

• Working Relationships/Contacts:

• Initiates and maintains effective working relationships with UBCP colleagues and other people with whom the incumbent must interact to perform their responsibilities

• Other Job Functions:

• Complies with all HIPAA regulation and UBCP standards of patient confidentiality.

• Accepts and performs other job related duties, projects and responsibilities, as required.

Must adhere to HIPAA regulations and maintain clinic, physician, RN and patient confidentially