Patient Care Coordinator
The Referral Coordinator is responsible maintaining ongoing tracking and appropriate documentation on referrals. Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist. Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis. Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians.
To perform effectively in this position, the incumbent must have:
1. High School graduate or Equivalent.
2. Shows proof(s) of documentation of training or certification his/her particular field.
3. At least (1) year experience with patient referral process.
4. Knowledge of managed care plans and requirements.
5. Knowledge of CPT and ICD-9 codes.
6. Capable of handling and maintaining confidential information in a professional manner.
7. Bilingual in English/Spanish.
8. Demonstrates strong written & verbal communication skills.
9. Demonstrates attention to detail.
10. Knowledge of State and County programs including eligibility requirements.
11. Proficient in Microsoft Office including Outlook, Word and Excel.
12. Must be able to gather and analyze information skillfully.
13. Must exercise good judgment.
14. Must be able to identify and resolve problems in a timely manner.