Medical Referral Coordinator

Job Summary
The Medical Referral Coordinator is responsible for managing and coordinating patient referrals within a healthcare facility or medical practice. They facilitate the seamless transfer of patients to specialists or other healthcare providers, ensuring timely access to necessary medical services.
Essential Duties and Responsibilities
  • Review medical records and clinical documentation to determine the need for specialist consultations or diagnostic tests.
  • Collaborate with healthcare providers to assess patients’ healthcare needs.
  • Identify appropriate specialists or facilities based on patients’ needs and insurance coverage.
  • Consult with physicians and patients to make informed referral decisions.
  • Schedule specialist appointments, diagnostic tests, and procedures for patients.
  • Coordinate appointment times, locations, and any necessary pre-visit requirements.
  • Maintain accurate and detailed records of patient referrals, including referral forms and documentation of communication.
  • Ensure compliance with documentation and data entry protocols.
  • Inform patients about their referral appointments, including date, time, location, and any special instructions.
  • Address patient questions and concerns related to referrals.
  • Verify patient insurance coverage for specialist visits and diagnostic tests.
  • Obtain any necessary pre-authorization or pre-certification from insurance providers.
  • Monitor and track the status of patient referrals, ensuring that appointments are kept and results are received.
  • Communicate with patients to confirm appointments and provide reminders.
  • Generate reports on referral activity, including tracking referral outcomes and referral volume.
  • Provide regular updates to healthcare providers and management on referral trends and issues.
  • Collaborate with healthcare providers and staff to identify opportunities for improving the referral process.
  • Implement quality improvement initiatives related to referral coordination.
  • Ensure compliance with healthcare regulations, including HIPAA and relevant state and federal guidelines.
  • Maintain confidentiality and security of patient information.
Education and/or Work Experience Requirements
  • High school diploma or equivalent; a post-secondary degree or relevant certification in healthcare administration may be preferred.
  • Previous experience in a medical office or healthcare setting is typically required.
  • Knowledge of medical terminology, healthcare procedures, and insurance practices.
  • Familiarity with electronic health record (EHR) systems and medical software.
  • Strong organizational and multitasking skills.
  • Excellent communication and interpersonal skills.
  • Detail-oriented, with a focus on accuracy and patient care.
  • Ability to work independently and as part of a healthcare team.
Physical Requirements
  • Sit or stand for extended periods of time.
  • Must be able to lift and carry, push or pull up to 50 lbs
  • Must be able to talk, listen and speak clearly in person and on the telephone.