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About the Role

The Referral Coordinator provides administrative support for patients, staff, and clinicians regarding referrals, authorizations, and scheduling. This role serves as the initial point of contact for external physicians and the public, ensuring critical information is relayed for patients referred to outside specialty services. The incumbent must possess exceptional public relations and customer service skills, effectively communicating with patients and physicians to identify needs and execute plans for registration, scheduling, insurance compliance, and general inquiries. Additionally, the Referral Coordinator assists in resolving issues, improving care quality, supporting PSR activities, obtaining necessary authorizations, managing patient check-in/check-out, updating demographics, and troubleshooting billing problems.

Responsibilities

• Coordinates the process of referring patients to appropriate clinics.
• Obtains authorizations as needed per specialty and insurance requirements.
• Explores insurance inconsistencies to assist registration and scheduling processes.
• Coordinates outgoing referrals and scheduling with destination specialty coordinators.
• Communicates with patients to ensure follow-through with referrals.
• Confirms any testing ordered in conjunction with specialty services is accounted for in the ordering and communication workflow.
• Participates in coordinating complex MFM patients into the UCSF Benioff Fetal Medicine Program under the direction of the Clinical Services Manager and Nurse Practitioner.
• Assists in coordinating and providing learning needs for PSR and MA teams specific to referrals and authorizations.
• Serves as the front line for triage of referral and authorization queries.
• Supports identifying and structuring workflow improvements, and staff education/support.
• Responsible for directing self-payment paperwork to Rev Cycle; reassigns if on PTO.
• Supports the Clinical Services Manager in monitoring Workques and identifying areas of needed support and learning.
• Answers phones professionally and warmly to assist all callers.
• Receives patients, providing information about services, insurance, and payment policies; handles registration; processes new patient paperwork; collects copays; and follows up on payments/insurance information.
• Schedules and confirms appointments, monitoring schedule capacity.
• Attends to billing corrections in a timely fashion.
• Distributes incoming paperwork, lab results, and scans records into patient charts via Epic/Right-Fax.
• Helps maintain office supplies, equipment, and general office systems.
• Attends to physician and practitioner needs to support patient care and practice development.
• Keeps patient demographics and insurance information accurate and up-to-date in the EHR.
• Provides friendly, knowledgeable, and responsive internal and external customer service.
• Reminds patients of appointments 72 hours in advance or as needed.
• Checks Right Fax throughout the day and returns patient calls the same day or within 24 hours.
• Utilizes EHR to communicate about appointment details and keeps administrative team members informed of patient/physician needs and schedule changes.
• Keeps Supervisor informed of customer compliments, complaints, or critical issues with clinical services.
• Maintains current knowledge of all physicians and services of the practice.
• Consistently extends a professional, warm environment using a pleasant tone of voice and maintaining composure.
• Attends staff and office meetings as required.
• Holds self and peers accountable to uphold the Standards of Behavior.
• Adheres to all UCSF Benioff Children’s Physicians policies and procedures, practices safe work habits, and engages in good business standards.
• Respects and is sensitive to cultural diversity, patient care, patient rights, ethical treatment, safety and security, teamwork, and demonstrates respect for others.
• Initiates and maintains effective working relationships with colleagues and others.
• Complies with all HIPAA regulations and UBCP standards of patient confidentiality.
• Accepts and performs other job-related duties, projects, and responsibilities as required.
• Maintains clinic, physician, RN, and patient confidentiality.

Requirements

• Demonstrated ability to remain professional, even when working through difficult situations.
• Must adhere to HIPAA regulations and maintain clinic, physician, RN and patient confidentiality.

Skills

• Public relations
• Customer service
• Communication
• Electronic Health Record (EHR) utilization
• Microsoft Outlook
• MS Office Suite
• Triage
• Scheduling
• Authorization processing
• Patient registration
• Billing correction
• HIPAA compliance
• AIDET skills

Location

• UCSF Benioff Children’s Physicians

Work Type

• Full-time

Experience Level

• Not specified

Education Level

• Not specified

About the Company

• UCSF Benioff Children’s Physicians

Equal Opportunity

• Holds self and peers accountable to uphold the Standards of Behavior regardless of race, ethnicity, culture, religious affiliation, disability, socioeconomic background, education, sexual orientation, marital status, gender, age or position.
• Respects and is sensitive to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, teamwork, and demonstrates respect for others.