Referral Coordinator
Summary
Coordinates patient referrals to specialists, verifies insurance coverage, schedules appointments, and ensures HIPAA-compliant documentation in a healthcare setting.
PRIMARY PURPOSE:
Managing the referral process efficiently to ensure patients and caregivers receive timely and appropriate specialist care. Plays a fundamental role in the healthcare system in facilitating seamless communication between patients, primary care providers, specialists and insurance companies.
ESSENTIAL JOB FUNCTIONS:
Referral Coordination:
- Managing patient referrals to specialists and other healthcare providers.
- Obtaining insurance authorization while verifying that the insurance is still active.
- Scheduling appointments, if needed, to coordinate patient visit care.
- Maintain accurate referral tracking and documentation for patient safety.
- Gather and provide relevant clinical background to specialists, per referral guidelines.
Insurance & Financial Navigation:
- Obtain insurance authorization if needed.
- Prompt follow-up on all referrals and track progress.
- Communicating with providers to close referral loops and ensure proper documentation.
- Update record to reflect completed referrals and outcomes.
Patient Support & Communication:
- Review referral details and expectations with patients.
Administrative & Compliance Duties:
- Ensure adherence to HIPAA confidentiality standards to protect patient information.
- Follow healthcare regulations to maintain ethical and legal compliance.
- Implement best practices for secure communication and data handling.
- Stay updated on emerging professional information.
- Comply with all FoundCare policies and procedures.