- Referral Financial Tracking: Reconcile incoming and outgoing patient referrals against billing records and third-party payer approvals.
- Provider Payouts & Commissions: Calculate and process payments or fee-splits for specialist doctors and referring physicians according to hospital contracts.
- Revenue Cycle Integration: Coordinate with the Referral Coordinator Job Description teams to link clinical data with financial billing codes, ensuring prior authorizations convert to collectible revenue.
- Audit & Compliance: Conduct regular reviews of referral-based financial transactions to ensure adherence to healthcare regulations and internal anti-kickback compliance.
- Reporting & Analysis: Generate periodic reports on referral profitability, leakage, and net realization rates for the hospital's finance committee.