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REFERRAL COORDINATOR - HMTS - HMG ADMINISTRATION (Newport Beach, CA, US)

Prepares clinical data for physician approval and obtains authorizations; acts as liaison between patient, medical assistant, physician, and Central Business Office.
Essential Functions Referrals Coordinator
Ensures all referrals are completed.
Ability to prioritize based on urgency of referral.
Processes authorization for consults and procedures on both fee-for-service as well as managed care patients.
Advises the patient of receipt/denial of authorization requests.
Maintains internal log of referral status per protocols of the medical office as well as documentation in the IDX system as outlined as outlined by CMS Department.
Ensures accurate and timely completion of forms to expedite patient care.
Supports referral process for all physicians, nurse practitioners, and physician assistants.
Performs advanced functions of the EMR which are beyond the abilities of front and back office users.
Ensures all authorizations are placed in the appropriate folder within patient charts.
Enforce the communication of direct and indirect referrals to manage patient expectations.
Provides excellent patient experience.
Education, Training and Experience
Required:
Referral Coordinator
Experience in outpatient health care system(s) including managed care.
High School diploma or equivalent
Preferred:
Previous experience with TouchWorks Utilization Standards
Trained in coding compliance
Skills or Other Qualifications
Required:
Strong problem-solving skills
Strong written and oral skills
Team oriented
Ability to manage multiple priorities with different and conflicting timelines
Detail oriented
Respectful of everyone with whom contact is made
Self-starter
Strong analytical skills
Values-oriented



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