POSITION PURPOSE:

Under the supervision of the Operations Support Manager, the Referral Coordinator utilizes established procedures to assist providers in referring patients to specialists outside of the clinic as appropriate. Ensures efficient and effective flow of referrals and medication pre-authorizations during scheduled clinic hours through joint planning and problem solving with clinic staff. Ability to keep several tasks moving along in a well-organized, compassionate, and professional manner while functioning at a high level of accuracy is critical.

ESSENTIAL FUNCTIONS:

• Collaborates with immediate supervisor and clinic providers to establish, define, and refine department goals and objectives consistent with Aviva Health’s Mission and demonstrates satisfactory progress towards these goals and objectives.
• Promotes a strong belief in Aviva Health’s philosophy, purpose, mission, and ideals.
• Demonstrates Aviva Health’s values and approaches all tasks with Aviva Health’s Mission, Vision, Values, and Customer Service statements as guidelines. Demonstrates care and compassion, respect, sharing, professionalism, confidentiality, collaboration, and teamwork. Takes personal responsibility.
• Promotes positive customer relations and service to both internal and external customers by providing referral services to all patients in a non-discriminatory, confidential, professional, friendly manner that builds dignity for each individual customer. Responds to co-workers’ needs and requests in a respectful, friendly, and prompt manner.
• Demonstrates respect and sensitivity to cultural/social differences in interactions with others.
• Communicates in an easy to understand, friendly, and professional manner; ensures understanding; provides additional information as needed.
• Displays a high level of initiative, effort, and commitment towards completing assignments efficiently. Works with minimal supervision and demonstrates responsible behavior and attention to detail.
• Demonstrates initiative and problem-solving skills using sound judgement. Assumes additional responsibilities as needed, with little or no direction, shows initiative in assisting others within the department.
• Complies with Aviva Health’s attendance and tardiness policies.
• Ability to establish and maintain effective working relationships with patients and co-workers.
• Completes assigned tasks in a timely manner.
• Communicates with patients any information required for referral appointments as needed. This may include date and time of appointments, location of specialist, explanation of the process and expected notification time, insurance status, and changes.
• Communicates with specialist to make patient appointments, fax all pertinent chart information, determine patient payment, and contact if appointment chart notes, and documentation is not received as needed.
• Work out of the EMR for referral orders and determine where to refer if the provider has not indicated a specific provider.
• For denied pre-authorization, notify the provider, review the denial and provide guidance regarding supporting documentation that may be required for approval, and refer the patient back to their primary care provider for further instruction.
• Process medication pre-authorizations.
• Process insurance referral authorization requests from external facilities.
• Other duties as assigned.

QUALIFICATIONS:

• High school diploma or GED.
• Develop and maintain positive relationships with medical professionals in the community.
• Maintains knowledge of and complies with OSHA requirements for the position.
• Displays a high level of initiative, effort, and commitment towards completing assignments efficiently. Works with minimal supervision and demonstrates responsible behavior and attention to detail.
• Maintains professional appearance, conforming to standards of dress and grooming as per company policy.