Referral Coordinator

Accountabilities:

Process and coordinate patient referrals in a timely and accurate manner, ensuring all required information and approvals are obtained.
Obtain physician approval for referrals and hospital admissions, coordinating with relevant healthcare professionals when necessary.
Act as a liaison between patients, physicians, insurance companies, specialists, and other healthcare providers to facilitate seamless referral management.
Contact insurance companies to obtain referral numbers, pre-certifications, and authorizations for medical procedures, specialist consultations, and hospital admissions.
Follow up with insurance providers regarding pending authorizations and ensure that referral requests are progressing within required timelines.
Schedule hospital admissions, outpatient procedures, and diagnostic tests, ensuring patients receive timely appointment information.
Notify patients of scheduled appointments and provide referral or authorization numbers as soon as they become available, ideally on the same day.
Document referral numbers, authorization details, and relevant information accurately in patient medical records.
Obtain and forward medical records from specialists and hospitals to support referral processing and authorization requests.
Fax referral documentation to specialists and direct patients to appropriate healthcare providers and vendors based on their insurance coverage.
Answer incoming telephone calls professionally, take accurate and complete messages, respond to non-clinical patient and family inquiries, and route clinical or other specialized questions to the appropriate personnel.
Maintain accurate records and follow established telephone communication and business office procedures.
Explain insurance-related information, including co-payments, co-insurance, deductibles, and coverage benefits, to help patients understand their financial responsibilities.
Manage additional administrative projects and responsibilities as assigned.
Provide support to other practices when necessary to accommodate patient volumes, staff absences, or operational requirements.
Requirements:
High school diploma or equivalent required.
At least one year of ICD-9 and CPT-4 coding experience is preferred.
Previous experience working with computers is required, with the ability to use standard office applications and administrative systems.
Strong knowledge of medical insurance plans, coverage benefits, referral procedures, and authorization requirements.
Familiarity with CPT, HCPCS, and ICD-10 coding systems, as well as co-insurance, co-payments, and deductibles.
Understanding of medical terminology and healthcare office procedures is preferred.
Proficiency in Microsoft Office applications, including Outlook, Word, Excel, and PowerPoint.
Ability to type at least 50 words per minute accurately and operate standard office equipment, including computers and photocopiers.
Excellent verbal and written communication skills, with strong English reading, writing, speaking, grammar, spelling, and punctuation abilities.
Professional telephone etiquette and the ability to communicate clearly, pleasantly, and effectively with patients, families, physicians, and insurance representatives.
Strong customer service skills, with a patient-centered approach and the ability to handle inquiries professionally and empathetically.
Excellent organizational and time-management skills, with the ability to prioritize multiple assignments, manage frequent interruptions, and meet strict deadlines.
Strong attention to detail and accuracy when processing referrals, documenting patient information, and handling medical records.
Effective problem-solving and critical-thinking abilities, particularly when navigating insurance requirements and referral challenges.
Ability to follow written and verbal instructions and work both independently and collaboratively within a team.
Flexibility to support other practice locations when operational needs require additional assistance.
Additional language skills are considered an advantage.
Benefits:
Competitive compensation: Hourly pay ranging from $17.28 to $27.65, depending on qualifications and experience.
Remote work: Fully remote working arrangement within the United States.
Comprehensive healthcare coverage: Medical, dental, and vision insurance available from the first day of employment.
Financial protection: Life insurance and disability insurance coverage.
Paid time off: Paid leave benefits available from the first day of employment.
Retirement savings: Access to a 403(b) retirement plan.
Paid parental leave: Four weeks of parental leave at 100% pay.
Career development: Opportunities for professional growth, training, and continued learning.
Well-being resources: Access to whole-person wellness programs and mental health support.
Additional perks: Pet benefits and other employee support resources.
Meaningful work: Opportunity to improve patient access to healthcare services and support efficient care coordination.
Collaborative environment: Work alongside healthcare professionals and administrative teams committed to delivering quality, patient-centered services.