Referral Coordinator at ELKO COMMUNITY HEALTH CENTER LLC

Description

Convergence Health is hiring a full-time referral coordinator to join our team. We are looking for a dynamic, energetic individual who will have a tremendous impact on patient care and access to multi-specialty services in and around Elko, Nevada. 

We are seeking someone adept at cultivating relationships with Providers, Community Partners, and patients as well as provide seamless coordination of patient referrals to ensure timely and efficient care transitions. 

About Us: 

At Convergence Health, we are proud to operate a State-Of-The-Art surgical facility equipped with the latest in medical technology. Our 30,000 square foot 3 OR, 2 Procedure room facility is co-located on a health campus with medical offices, an infusion center, imaging, among other services. Our commitment to excellence in patient care is matched only by our dedication to fostering physician satisfaction and building great healthcare teams. Here, you’ll have the opportunity to shape clinical practices and influence the future of surgical care in our Community.

Position Summary:

The Referral Coordinator is responsible for managing and processing patient referrals to specialty providers, imaging centers, and other healthcare facilities. This role ensures timely coordination of care by verifying insurance requirements, securing necessary authorizations, scheduling appointments, and communicating referral details to patients and providers. The Referral Coordinator plays a key role in promoting a smooth patient experience and supporting the clinical team in delivering high-quality care.

Key Responsibilities:

Referral Management:

• Receive  and process referrals from providers in the clinic’s EHR system.
• Review  referrals for completeness, accuracy, and compliance with insurance requirements.
• Obtain prior authorizations and pre-certifications as required by insurance carriers.
• Track referral status and follow up with patients, providers, and specialists to ensure timely scheduling.
• Maintain accurate and up-to-date referral logs and documentation.
• Establish appropriate face to face meeting cadence with Providers and Community Partners as well as ability to attend events to represent Convergence Health.

Patient Communication:  

• Inform patients of referral details, specialist contact information, and appointment instructions.
• Provide  education to patients about insurance requirements, co-pays, and follow-up steps.
• Serve as a point of contact for patients with questions about referral status.

Provider & Clinic Support

• Communicate  with providers regarding referral updates, delays, or authorization       issues.
• Coordinate with front desk, medical assistants, and nursing staff to support       continuity of care.
• Ensure  referral documentation is available in the patient chart before the       visit.
• Closed loop communication with referring Provider regarding their patients care.

Insurance & Compliance

• Verify patient insurance coverage for specialty services.
• Ensure all referrals comply with HIPAA and organizational privacy standards.
• Work with billing staff to prevent claim denials related to referral and authorization issues

Skills:

• Strong  organizational and time management skills.
• Excellent  communication skills, both verbal and written.
• Knowledge of medical terminology, referral processes, and insurance guidelines.
• Ability to work independently and collaboratively in a fast-paced environment.

Working Conditions:

• Standard medical office environment.
• Regular interaction with patients, providers, and external healthcare facilities.
• May require extended periods of sitting, computer use, and telephone      communication.
• Ability to travel as needed throughout Community

Core Competencies:

• Attention to detail and accuracy.
• Patient-centered communication.
• Problem-solving and follow-through.
• Professionalism and teamwork.

Benefits Overview: Comprehensive benefits package, including:  Medical, Vision, and Dental insurance (with HSA options) with 80% Employer paid premiums. Employer paid Life insurance, Short- and Long-Term Disability coverage, and a 401(k) Savings Plan with employer matching up to 4%, (subject to a vesting schedule). Generous PTO/Sick time and paid holidays. 

Requirements

 Required: 

• High school diploma or equivalent required; medical office or healthcare administration coursework preferred.
• Ability to travel as needed to Provider offices and Community events 
• NV  Driver’s license and clean driving record as well as appropriate insurance coverage 
• Minimum 1–2 years of experience in a medical office, referral coordination, or health insurance environment.
• Experience with electronic health records (EHR/EMR) and insurance authorization systems preferred.