Referrals Coordinator

This is a hybrid position with responsibilities that may vary based on clinic needs. The employee will primarily support referral coordination while also assisting with Front Desk and/or Call Center duties as needed, including providing coverage during peak times, absences, or workflow fluctuations.

The Referrals Coordinator plays a key role in managing and coordinating patient referrals to external specialists or other healthcare providers. Duties include verifying insurance coverage, obtaining any necessary pre-authorizations, maintaining accurate records in compliance with HIPAA regulations, and facilitating communication between providers and specialists. The Referrals Coordinator answers any patient questions or concerns regarding the referral process and provides status updates on referral and authorization decisions.

• Manage the comprehensive process of all patient authorizations and referrals.
• Ensure timely and accurate processing of referral requests from both patients and providers.
• Verify patient insurance eligibility and benefits, securing necessary pre-authorizations from insurance carriers for specialist consultations.
• Utilize medical coding systems such as ICD-10 for proper documentation of patient diagnoses.
• Prepare and transmit relevant patient medical information to the specialist's office, keeping accurate and complete documentation of all related communications.
• Maintain accurate and detailed records of all patient referrals.
• Actively monitor and track the status of patient referrals, ensuring that appointments are attended and notes are successfully received.
• Serve as the primary point of contact for patients, addressing all inquiries and concerns regarding their referrals.

• Create a positive and welcoming atmosphere in the Front Office / Reception area.
• Greet patients upon arrival and manage the check-in process.
• Collect patient payments, including copays and outstanding balances.
• Schedule follow-up and future patient appointments.
• Answer and manage incoming phone calls and emails.
• Organize and file documents to ensure patient records are current and accurate.

• Facilitate smooth patient flow by communicating effectively with healthcare providers and the Back Office patient care team.

• Complete other tasks or projects as assigned.

• Maintain professional relationships, demonstrating excellent customer service and a consistently professional demeanor.
• Ensure strict adherence to HIPAA regulations and all practice guidelines concerning patient privacy and the referral process.

• High School Diploma or GED.
• Availability to work full-time, Monday through Friday, from 8:30 AM to 5:30 PM.
• Ability to work in both our Larkspur and Novato office locations.
• Full vaccination against COVID-19 and willingness to receive annual flu vaccines.

• Two years experience working in a medical office is preferred.

• Healthcare and Administrative Expertise:
• Prior experience managing referrals, insurance verification, and prior authorizations is essential.
• Previous work experience in a healthcare facility or environment.
• Solid understanding of medical terminology and standard insurance practices.
• Familiarity with Electronic Health Records (EHR) systems and proficiency in navigating insurance portals for verification and pre-authorization requests.
• High level of computer literacy.
• Organizational and Task Management:
• Ability to efficiently manage a high volume of simultaneous referrals, prioritize tasks effectively, and maintain meticulous documentation.
• Must be detail-oriented.
• Excellent multi-tasking skills.
• Ability to work both independently with minimal supervision and collaboratively as part of a team.
• Communication and Interpersonal:
• Exceptional written and verbal communication skills.
• Excellent customer service skills.
• Ability to communicate clearly and professionally, both in person and over the phone.
• Professional appearance and demeanor are required.
• Highly Desired:
• Bilingual proficiency in Portuguese and/or Spanish.

We offer medical, dental, vision, 401(k), PTO and sick pay, paid holidays, life / accident insurance, an Employee Assistance Program (EAP), and are closed most weekends.

In accordance with California law, the expected hourly range for this California position is between $25 to $30 per hour. The actual compensation will be determined based on experience and other factors permitted by law.

Tamalpais Pediatrics is an equal opportunity employer who does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability, or any other characteristic protected by law.