Coordinates specialty and diagnostic imaging referrals by tracking documentation, verifying patient registration and insurance details, gathering clinical information, securing prior authorizations, communicating with specialists and review organizations, and explaining referral requirements to patients. The role supports timely access to care and patient safety while collaborating with patients, families, and care teams.
Referral Navigator
SUMMARY: The Referral Navigator works closely with patients, families, and the care team to ensure timely access to specialty and diagnostic imaging referrals.
QUALIFICATIONS:
- High school diploma or equivalent and have strong organizational skills with demonstrated proficiency in computer applications (Microsoft Office).
- Epic Ambulatory experience is a plus.
- Graduate of a medical secretary program preferred.
- Excellent communication skills (written and oral) professional demeanor, good problem solving skills, organized and detail-oriented.
- Understanding of Medicare, Medicaid and managed health care plans are necessary qualifications for this position.
- English / Spanish bilingual ability is preferred.
EXPERIENCE:
- Previous experience working in a medical office, clinic or hospital with demonstrated attention to detail, preferred.
- Equivalent experience in the field of social services a plus
DUTIES AND RESPONSIBILITIES:
- Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness and ensure patient safety.
- Ensure complete and accurate registration, including patient demographic and current insurance information.
- Assemble information concerning patient's clinical background and referral needs.
- Per referral guidelines, provide appropriate clinical information to specialist.
- Contact review organizations and insurance companies to ensure prior approval requirements are met.
- Present necessary medical information such as history, diagnosis and prognosis.
- Review details and expectations about the referral with patients.
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269 Union St, Lynn, Massachusetts, United States, 01901 1314
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Lynn Community Health Center Lynn, Massachusetts, USA Office
280 Union St, Lynn, Massachusetts, United States, 01901 1353
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