Referral Coordinator – Deland Spring Garden

Job Description

Position Summary

The Referral Coordinator is responsible for coordinating specialty care for patients in need of external consultation as requested by the primary care physician.  Following the Island Doctors protocol, the Referral Coordinator researches referral requests in a timely manner and ensures it meets medical necessity with thorough documentation.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Processes patient referrals to specialty providers and facilities while adhering to Island Doctors protocol.
• Ensures that referrals are addressed in a timely manner, prioritizing urgent items appropriately.
• Reviews documentation from primary care provider or specialty provider to ensure medical necessity of the referral request.
• Prepares and submits Service Denials on referral requests that do not meet Island Doctors protocol. Reviews Service Denial with Director or Supervisor prior to submission to payor as needed.
• Prepares medical records to accompany referral, providing appropriate clinical information to specialist.
• Acts as a resource for patients or providers who have questions or problems relating to referrals.
• Maintains log of all referrals processed; submits log to District Manager or Supervisor monthly.
• Communicates internal and external referral request issues with District Manager or Supervisor in a timely manner.
• Performs other duties as assigned.

Minimum Qualifications (Knowledge, Skills, and Abilities)

• High school diploma required
• Previous medical office experience preferred
• Strong customer service focus
• Effective verbal and written communication skills
• Teamwork orientation
• Ability to remain highly organized and manage competing priorities
• Ability to utilize sound judgment and resourcefulness in problem solving
• Ability to follow through with delegated tasks and accountability

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

The company is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.