Administrative & Referral Coordinator - Orthopedic Surgery

Overview

POSITION SUMMARY:

The Administrative & Referral Coordinator provides liaison support for patients regarding care in the Orthopedic Clinic. Facilitates access to care, gathers registration information, schedules appointments, verifies demographics and financial information, and obtains pre-authorizations from insurance carriers. Responds to inquiries from patients, BMC departments, and external facilities. Supports department targets and ensures effective communication among patients, providers, nursing staff, medical assistants, referring physicians, and office support personnel.

• Registration/Admission/Pre-Scheduling: interview patients, families or referring physicians to obtain required financial and demographic information; enter data into registration systems to ensure proper reimbursement; verify third-party coverage and day-of-service eligibility; direct patients with financial concerns to appropriate staff; collect deposits for co-pays; update demographics and provider information; assign medical record numbers; prepare and transmit necessary information for surgical or non-surgical visits.
• Pre-authorization and Referral Management: obtain prior approval numbers from insurance carriers; document approval details in the registration system; process referrals, prepare paperwork for managed care authorizations, and coordinate with providers and staff; identify patients requiring authorization and obtain provider approval before appointments; communicate alternatives if service is denied; generate audit reports to monitor referral processes and identify inefficiencies.
• Coordination and Communication: coordinate primary care provider assignments, enrollments, disenrollments and transfers; act as a resource on managed care guidelines; participate in managed care orientations and train staff on procedures; update schedules and communicate with labs, radiology, and billing as needed.
• Appointment Scheduling: use computer and scheduling software to book follow-ups, H&Ps, and ancillary appointments; monitor physician schedules for conflicts; perform cross-booking for social services and other clinical areas; reschedule canceled procedures and facilitate urgent surgical appointments.
• Training and Quality: attend system trainings; participate in committees as required; assess training needs and develop staff competency; monitor registration quality, no-shows, and billing edits; implement corrective actions as needed.
• Patient Flow and Satisfaction: monitor patient flow, troubleshoot issues, and collaborate with leadership to enhance efficiency and satisfaction.

• Education:
  
  High School diploma required;
  Associate or Bachelor’s degree preferred.
• Experience:
  
  Minimum ~3 years in financial clearance, managed care, or referral scheduling; working knowledge of HMO, PPO, and insurance approvals; experience handling patient flow is advantageous.
• Technical
  
  Skills:
  
  Strong computer skills; proficiency with Windows, Microsoft Office; familiarity with EPIC, Caretracker, IDX or comparable registration systems; ability to use registration and scheduling software.
• Communication:
  Excellent English communication skills (verbal and written); professional demeanor; ability to interact effectively with all levels of staff and patients; strong interpersonal and empathetic skills; ability to maintain confidentiality.
• Other:
  Ability to multitask, take initiative, work independently, and manage competing priorities; team player with cross-organizational collaboration skills.

Compensation Range: $21.39 - $30.05 per hour. This range reflects minimum qualifications and may vary based on education, experience, skills, and certifications. Boston Medical Center offers a comprehensive benefits package including medical, dental, vision, life, and retirement plans, paid time off, and opportunities for career advancement.

Boston Medical Center is an equal employment opportunity/affirmative action employer. We provide accommodations for individuals with disabilities in the application process upon request. We participate in the Electronic Employment Verification Program (E-Verify) and require appropriate background checks and vaccinations as applicable. For any accommodation needs during the application process, please contact Talent Acquisition.