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Referral Coordinator

Department: Billing - Indirect
Location: Snellville, GA
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MISSION

The Administrative Coordinator is responsible for performing verification and obtaining authorization for appointments that require an insurance referral. This individual also serves as an administrative support to the revenue cycle department. The role involves building coordination, administrative tasks, insurance verification, decision-making, communications, collaboration, organizational skills, writing and daily presence in the office.

OUTCOMES

  • Maintains tracking of patients on schedule, ensuring that the correct insurance plan, eligibility, and referral authorization information has been entered into data entry systems accurately along with documenting applicable notes or review secure notes, while coordinating and performing verification of insurance benefits for appointments that require a referral.
  • Acts as a liaison between clinical staff, patients, physician, and insurance payor by informing patients of referral /benefit delays/denials, answering questions, educating patients about their benefit, and offering assistance.
  • Reschedule/cancel patients in the data entry system accordingly due to verification/authorization related issues.
  • Provides clinical information as needed to emphasize medical justification for procedure/service and contacts primary care physicians or insurance company when applicable.
  • Assist with medical records.
  • Actively sorts mail and correspondences per Advanced Urology protocols.
    • Assists in mail distribution and escalating urgent correspondence for review to appropriate stakeholders.
  • Prepares expense reports, invoices, and serves as the point of contact to notarize documents.
  • Engages in event planning and meeting set up, while serving as an initial point of contact to answer phones and greet visitors.
  • Manages building activity to ensure cleanliness, safety, supply inventory or general day to day facility responsibilities May require travel to ensure items are available in the department.
  • Perform other projects and duties as assigned.

COMPETENCIES

Job Related Competencies:

  1. Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
  2. Interpersonal Savvy: Relating openly and comfortably with diverse groups of people.
  3. Drive Results: Consistently achieving results, even under tough circumstances.
  4. Plans and Aligns: Planning and prioritizing work to meet commitment aligned with organizational goals.
  5. Resourcefulness: Securing and deploying resources effectively and efficiently.

Cultural Competencies:

Advanced Values:

  1. People
    • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives
  2. Heart
    • Patient Focus: Building strong patient relationships and delivering patient centric solutions.
  3. Service
    • Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity.
  4. Excellence
    • Cultivates Innovation: Creating new and better ways for the organization to be successful.

Behaviors:

  1. Being Resilient:
    • Rebounding from setback and adversity when facing difficult situations
  2. Self-Development:
    • Actively seeking new ways to grow and be challenged using both formal and informal development challenges.
  3. Optimizes Work Processes:
    • Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement.
  4. Professional Communication:
    • Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone.

QUALIFICATIONS

Basic Qualifications:

Education:

  • High School Diploma or GED.

Previous, Job Relevant Work Experience:

  • 2+ years of experience in healthcare or access related position.
  • Working knowledge of basic medical terminology.
  • Proficient in Microsoft Office Suite and insurance websites.
  • Must be able to speak and write in a clear and concise manner to convey messages and ensure that the customer understands whether clinical or non-clinical.
  • Demonstrate a high level of professional conduct with colleagues, staff members, leadership, and internal/external customers.

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