Referral Coordinator I

Florida Medical Clinic Orlando Health 

Job Title: Referral Coordinator I

Position Summary: The Referral Coordinator supports Clinical teams, Patients and Family Members by managing referrals and/or authorizations for the Medical Group. They are responsible for processing Internal and External referrals and authorizations from orders prescribed, by the provider, in the Electronic Health Record (EHR) system within the Outpatient Ambulatory setting.

Experience with obtaining authorizations from commercial and HMO plans desired.  Bilingual (Spanish) a plus but not required. 

Location: 27343 Wesley Chapel Blvd. Wesley Chapel 

This full time opening is for a referral clerk within our Zephyrhills radiology department. This role is responsible for obtaining authorizations for Radiology exams such as MRI and CT scans.  Responsible for assisting patients and co workers as needed. Maintain an efficient and organized work environment in a busy radiology office. Must be able to perform multiple duties with ease. Bilingual (Spanish) strongly preferred. Medical office experience desired.

Essential Functions

• Completes entry of referrals and/or authorizations into EHR.
• Completes registration and obtains insurance authorization for new patients, diagnostic testing and for hospital diagnostics.
• Coordinates follow-up care with the referral as the referral expires.
• Ensures financial information and insurance is current and active.
• Ensures Primary Care provider is accurate based on payer guidelines.
• Updates patient insurance information in EHR systems as needed.
• Transcribes faxed referral requests via On-Base fax system into EHR.
• Initiates the referral and authorization process for visits and services.
• Works closely with clinical teams to facilitate optimal patient care.
• Coordinates with scheduling departments, and other departments as needed to facilitate patient’s visit.
• Coordinates with Patients when necessary to complete referral.
• Provides patient with referral information for physicians and facilities.
• Communicates effectively with all internal and external customers – PCP, Patient, clinical departments, etc. to obtain the required authorization needed for each visit or service.

• Maintains current knowledge of referral and authorization requirements based on payer specific guidelines.
• Maintain working knowledge of ICD-10 and CPT codes.
• Demonstrates a basic knowledge of third-party reimbursement requirements and regulations.
• Exhibits competency in the use of registration systems, electronic verification tools and Web-based resources.
• Understands the importance Orlando Health places on providing exemplary customer service.
• Performs job in a manner that helps meet customer service goals.
• Demonstrates a positive and professional approach and communicates effectively with customers and team members at all times.
• Maintains flexibility in work schedule availability that allows department to change/modify work schedule to meet departmental needs.

• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal,state, and local standards.

• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions

• Attends and participates in department staff meetings and other meetings as assigned.
• Responsible for maintaining performance measures as outlined by the department’s productivity guidelines.

Education/Training

High School Graduate

Medical Terminology

Licensure/Certification

None

Experience

• Two (2) years of directly related work experience preferred.
• Experience in processing physician office and/or hospital referrals Proficient in Computer usage.

Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here.

Florida Medical Clinic Orlando Health is a drug-free workplace and maintains a policy in which new hires will be required to submit to pre-employment drug testing. This policy is intended to comply with applicable laws regarding drug testing and any privacy rights