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Peninsula Regional Medical Center Coordinator - Referral in Salisbury, Maryland

Position Summary

The Referral Coordinator is responsible for the coordination and scheduling a wide variety of specialty care, consults and diagnostic testing, including follow-up to ensure that referral appointments were kept and results received in order with the goal of "closing the loop" for 100% of the referrals made by Tidal Offices. The Referral Coordinator synchronizes the scheduling and tracking of referrals, including pre-certification, registration and other related issues. Verifies insurance coverage and obtains authorizations from Payers as needed. Abstracts necessary clinical data pertinent to the referral from the appropriate source. Provides quality control oversight by ensuring that all information pertinent to the referral is documented in the appropriate place in the patient's electronic health record (Epic), correcting inaccurate information when necessary. Acts as a liaison between hospitals, physician offices, health plans, laboratories, testing facilities, specialty services and patients. Serves as the system navigator and point of contact for patients and families. Documents communications, actions and other data related to referrals in the EMR. Assumes overall responsibility for obtaining, tracking and accurately documenting assigned referrals to ensure a closed loop process.

Position Requirements

Education

  • High school diploma required.

  • Associates degree in business or healthcare related field, or Medical Assistant/Medical Office Administrator Certification strongly preferred.

Experience

  • Minimum of two years of experience in a healthcare setting.

  • Must be familiar with medical terminology.

  • Significant knowledge of various insurance plans including Medicare, Medicaid and commercial insurance required.

  • Proficiency with computer software, including an EMR, required

  • Strong communication (oral and written) skills and organizational skills required.

  • Knowledge of ICD-10 and previous experience with referrals strongly preferred.

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