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Referral Coordinator

Referral Coordinator

Rainbow PediatricsFayetteville, NC, US
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Job Description

Job Description

Description : About Playground :

At Playground Pediatrics, our purpose is to give every child what they need to grow up healthy, cared for, and celebrated. We are writing a new chapter for children’s health by strengthening pediatric care and support within communities that we serve. If you are motivated to advance the future of pediatric care, we would love to have you join our team.

Values that bring you to Playground :

  • You question the way things have always been and explore what could be better
  • You hold yourself accountable to do what’s right, always putting the needs of children and families at the center of decisions
  • You assume good intent, listen first, and treat every interaction as a chance to build trust
  • You bring energy and passion into your work
  • You embrace challenges and believe that you can build something better

POSITION SUMMARY :

The Referral Specialist is responsible for providing customers / patients with exceptional, friendly, and professional customer service experience. This role is responsible for coordinating the specialty clinics by managing the waiting lists, scheduling the patients, and working on follow-up items after the clinic visits take place.

ESSENTIAL RESPONSIBILITIES : To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

Referral Duties

  • Maintain ongoing tracking and appropriate documentation of referrals to promote team awareness and ensure patient safety.
  • 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 practice.
  • Review details and expectations about the referral with patients.
  • Assist patients in problem solving potential issues related to the health care system, financial or social barriers.
  • Ensure that referrals are addressed in a timely manner.
  • Ensure that patient’s primary care chart is up to date with information on specialist consults, hospitalizations, ER visits and community organization related to their health.
  • Manage documentation with a high level of accuracy and attention to detail.
  • Other Responsibilities

  • Maintain strict confidentiality; adheres to all OSHA, HIPAA, and other federal, state, and local guidelines / regulations.
  • Demonstrate dedication to the mission, vision, values, and goals of the organization.
  • Regular and reliable attendance including attending monthly staff meetings.
  • Perform other duties as assigned.
  • KNOWLEDGE AND SKILLS : The requirements listed below are representative of the knowledge, skills and / or abilities required.

    Education and / or Experience : High School diploma or GED required. Minimum one (1) year of referral experience, healthcare experience preferred. Medical Assistance (MA) or Licensed Practical Nurse (LPN) preferred.

    Supervisory Responsibilities : No

    Computer Skills / Technical Knowledge : Proficient in the use of Microsoft Office Suite and familiarity of various EMR systems. General knowledge of computer applications for the frequent use of electronic mail, word processing, data entry, spreadsheets, graphics, etc.

    Mathematical Skills : Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals, and percentages. Ability to understand and identify statistical trend analysis. Ability to identify numerical trends and variances for financial analysis.

    Language Skills : Ability to understand, read, write, and speak English. Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, safety data sheets (SDS) or governmental regulations. Ability to effectively present information, respond to questions and professionally interact with managers, employees, patients, vendors, the public, and diverse groups of people, particularly difficult / resistant patient populations and multiple types of providers in a variety of settings.

    Reasoning Ability : Must be able to apply principles of logical thinking to define problems, collect pertinent data, establish facts, draw valid conclusions, and initiate appropriate course of action.

    Other Qualifications : The ability to think critically, solve complex challenges and productively manage conflict. Must be able to handle multiple, simultaneous tasks effectively and efficiently. Strong verbal and written communication skills required. Must be detail oriented and organized with the ability to perform duties under pressure, prioritize workload, and timely meet deadlines. Must have the aptitude and ability to self-direct work.

    PHYSICAL AND MENTAL DEMANDS : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential job responsibilities.

    While performing the duties of this job, the employee is occasionally required to stand; sit; walk for extended periods of time; use hands to touch, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch, or crawl; talk or hear; taste or smell. The employee must occasionally lift and / or move up to 15 pounds. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

    While performing the duties of this job, the employee must be able to work in a fast-paced, sometimes stressful, customer service, health care-oriented environment, perform duties under pressure and meet deadlines in a timely manner. The employee must work as part of a team, complete assignments independently and take instructions from others.

    WORK ENVIRONMENT : Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

    Works in well-lit, ventilated and climate-controlled medical office environment where routine equipment is used; some equipment has moving mechanical parts. May be exposed to hot and cold temperatures.

    Must possess reliable transportation, a valid driver’s license and maintain an acceptable driving record in accordance with company policy.

    Must maintain a full-time, on-site schedule with the potential of weekends and nights as required. Minimal, if any travel required.

    Requirements :

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