Referral Coordinator

PRIMARY PURPOSE:

Managing the referral process efficiently to ensure patients and caregivers receive timely and appropriate specialist care. Plays a fundamental role in the healthcare system in facilitating seamless communication between patients, primary care providers, specialists and insurance companies.

ESSENTIAL JOB FUNCTIONS:

Referral Coordination

• Managing patient referrals to specialists and other healthcare providers.
• Obtaining insurance authorization while verifying that the insurance is still active.
• Scheduling appointments, if needed, to coordinate patient visit care.
• Maintain accurate referral tracking and documentation for patient safety.
• Gather and provide relevant clinical background to specialists, per referral guidelines.

Insurance & Financial Navigation

• Obtain insurance authorization if needed.
• Prompt follow-up on all referrals and track progress.
• Communicating with providers to close referral loops and ensure proper documentation.
• Update record to reflect completed referrals and outcomes.

Patient Support & Communication

• Review referral details and expectations with patients.

Administrative & Compliance Duties

• Ensure adherence to HIPAA confidentiality standards to protect patient information.
• Follow healthcare regulations to maintain ethical and legal compliance.
• Implement best practices for secure communication and data handling.
• Stay updated on emerging professional information.
• Comply with all FoundCare policies and procedures.
• Performs other duties as assigned.