POSITION SUMMARY:
The Referral Coordinator is responsible for the processing and coordination of patient referrals to help provide the best patient care team. Assists providers and patients, when necessary, with the referral process for specialty care, diagnostic services to ensure continuity of care utilizing the protocols required by various health plans.

ESSENTIAL DUTIES:

Reviews referrals to confirm or obtain insurance authorization. If no authorization, returns referral to referring provider’s office via electronic medical record system.
Explains whether provider participates with patient’s insurance and if not, describes options for payment.
Contact specialty partners and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as history, diagnosis and prognosis.
Be the navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns regarding their referrals.
Answer telephone promptly and in a polite and professional manner, following call center scripts.
Handles all incoming telephone calls from patients and answers general referral questions and inquires.
Receives, directs, and relays telephone and fax information.
Responsible for inputting very detailed information on the patients using a variety of computer screens.
Secures patient information and maintains patient confidence by completing and safeguarding medical records, completing diagnostic and procedure coding and keeping patients information confidential.
Follows up with patients regarding pending referral/authorization.
Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
Other duties as assigned.

POSITION REQUIREMENTS:
A.KNOWLEDGE, SKILLS AND ABILITIES:

Knowledge of EMR systems preferably Athena
Knowledge of basic medical terminology
Ability to operate basic office equipment
Proper telephone etiquette
Ability to read, understand and follow oral and written instructions
Must be well organized and detail-oriented
Have the ability to respond well under pressure
Promotes a professional, productive and positive work environment
Knowledge of medical terminology
Familiarity of clinic protocols and policies
Knowledge of HIPAA
Knowledge of EMR, health insurance
Skilled in multitasking effectively and answering multiple phone calls
Skill in conducting cooperative interactions with patients and staff
Skills in prioritizing tasks and time management.
Strong organizational skills
Ability to provide excellent customer service
Ability to interpret and respond appropriately to instructions
Ability to build rapport with patients and co-workers
Ability to recognize the need to escalate calls to manager, nurse or provider as necessary
Ability to exercise sound judgment in handling calls, especially with dissatisfied patients

QUALIFICATIONS:
B. EDUCATION, EXPERIENCE AND SKILLS REQUIRED:

High School Diploma or equivalent
Minimum of 1-2 years’ experience in administrative medical office setting and Insurance & referral knowledge

BENEFITS:

Competitive salary based on experience
Health, dental, and vision insurance options
Paid time off and holidays
401(k) plan with employer contribution after 1 year of service
Opportunities for professional development
Fun work environment with Employee Appreciation and Engagement events

EMPLOYER'S RIGHTS: This job description does not list all the duties of the job. You may be asked by your supervisors or managers to perform other duties. You will be evaluated through the performance evaluation system and part of that evaluation will be based upon your performance of the tasks listed in this job description.

The Diabetes & Glandular Disease Clinic, P.A. (DGD) offers the best in treatment for hormonal and metabolic disorders such as type 1 and 2 diabetes, gestational diabetes, thyroid disease, osteoporosis, lipid disorders (high cholesterol), pituitary/adrenal gland problems, menstrual disorders and hirsutism (excessive facial hair on women). All our doctors are board-certified in Endocrinology & Metabolism, a sub-specialty of Internal Medicine. The clinic was founded in June of 1979. Four years later, in June of 1983, the clinic was instrumental in establishing the Diabetes Centers of Excellence at what is now Methodist Specialty and Transplant Hospital. Under our physicians' guidance and direction, the Centers of Excellence received recognition from the American Diabetes Association (ADA) and was the only in-patient facility recognized in South Texas. At this same time, the Diabetes & Glandular Disease Research Center was born and the clinic conducted its first clinical trial of an investigational new drug. Since then, we have conducted more than 500 such research trials. In April of 1993, the Diabetes Self-Management Training Center, commonly called the Education Center, was created. At present, the Education Center is recognized by the ADA and is the first of its kind so recognized in the state of Texas. We provide education for type 1, type 2, and gestational diabetics along with insulin adjustment and out-patient insulin pump training. DGD continues to be a leader in progressive use of the most current, state-of-the-art technologies and cutting-edge treatments. Because of this, the clinic has become internationally renowned for its care of patients with diabetes mellitus, as well as other endocrine disorders, and has remained one of the largest endocrinology clinics in South Texas.

Referral Coordinator/MA

Referral Coordinator/MA

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