University of Florida Jacksonville Healthcare, Inc.

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Referral Coordinator

at University of Florida Jacksonville Healthcare, Inc.

Posted: 6/7/2019
Job Status: Full Time
Job Reference #: 4190
Keywords:

Job Description

Scope of the Job
This position is responsible for processing referral requests for all providers practicing within the clinic module and ensuring that when needed, referral/authorization numbers are obtained for these services.
Access to specialty and ancillary services is a key component of the satisfaction of our patients and referring providers.  The responsibilities of this position are extremely important in meeting or exceeding customer satisfaction.

Essential Functions
1. Attends Referral training class and various referral system training classes within 1st month of employment
2. Attends and actively listens and participates in the regularly scheduled Referral Coordinator meeting
3. Process referrals for services requested by Providers within established guidelines, to include external referrals
4. Obtains authorizations for referrals and schedules appointments as appropriate and within required timeframes
5. Processes requests for additional referrals/authorizations when requested by providers
6. Assures referrals are maintained within appropriate network or payer requirement
7. Provides a standard of excellence as it relates to customer service and satisfaction for all customers.
8. Communicates with all stakeholders, staff, providers, payers and patients as appropriate and per procedure
9. Remains current on referral policies and procedures, payer requirements and Managed Care Matrix utilizing the various on-line resources
10. Documents required information into the appropriate systems
11. Maintains patient privacy
12. Participates in performance improvement projects
13. Participates as an active care team member in the coordination of patient care.

Secondary Functions
Performs routine CSR duties as required
Adheres to all regulatory requirements such as JCAHO, CLIA, HIPAA, etc.

Temperament
Must be able to perform under stress when confronted with emergency, critical, or unusual situations.
Must be capable of dealing with periodic cyclical workload pressures and levels of responsibility.
Required to make independent judgments without supervision.  Must be able to make generalizations, evaluations, or decisions based on sensory or judgmental criteria.
Must have the adaptability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure.
Requires the ability to work with people beyond giving and receiving instructions.
 

 

SKILLS, QUALIFICATIONS, AND REQUIRED EXPERIENCE
Skills

Knowledge of insurance plans and guidelines
Ability to obtain authorizations and pre-certifications from insurance plans
Excellent customer service skills
Ability to multitask in a fast paced environment
Ability to communicate effectively, both written and orally
Above average organizational skills

Experience
2 years experience in the field or in a related area
Minimum of 2 years customer service experience
Minimum of 2 years with third party payers (insurance carriers) using commonly used concepts, practices and procedures in the field
Computer experience required

Education and Certifications
High school diploma or GED equivalent required 
ICD-9 and CPT coding experience preferred 
Completion of a medical terminology course preferred

UFJPI is an Equal Opportunity Institution