Referral Coordinator - Cardiology

Position Summary:

This position will be part of the Orlando Health Medical Group/Bayfront Medical Group in St. Petersburg, Florida at the Crossroads FSED

Schedule: Full-time; M-F 40hrs per week

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.

Responsibilities:

• Perform front office duties including checkin in and checking out patients.
• Completes entry ofreferrals and/or authorizationsinto 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.
• Schedules appointments and manage the appointment calendar
• Coordinates with scheduling departments, and other departments as needed to facilitate patient’s visit.
• Ensures Primary Care provider is accurate based on payer guidelines.
• Updates patient insurance information in EHR systems as needed.
• Verifies patient eligibility and process insurance information.
• Transcribes faxed referral requests via On-Base fax system into EHR.
• Initiates the referral and authorization processfor visits and services.
• Works closely with clinical teams to facilitate optimal patient care.
• Coordinates with Patients when necessary to complete referral.
• Manages referrals and obtains necessary authorizations.
• Collect co-pays and handles patient billing inquiries
• 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 ofreferral and authorization requirements based on payerspecific 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 ofregistration 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 helpsmeet 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.
• Attends and participates in departmentstaff meetings and other meetings as assigned.
• Responsible for maintaining performancemeasures as outlined by the department’s productivity guidelines.
• Provide general non clinical support as needed.

Qualifications:

• Minimum High School Diploma or equivalent required.
• Medical Terminology

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