Referral Coordinator

Referral Coordinator is responsible for processing reputed company incoming referrals by various methods including external physicians and APPs, insurance payers, online reputed company, etc. Responsibilities include obtaining, validating, and tracking of referrals/prior authorizations/reauthorizations with requirements that vary based on patient insurance plans.

• Communicate, build relationships, and liaise between PCPs, other specialists, and patients in referral approval process
• reputed company chart prep audits to identify and work missing referrals/authorization prior to patient appointments (timing is critical)
• Incoming/Outgoing phone calls to patients, other medical practices, and medical insurance companies
• Work daily batch files, print, reputed company, and reputed company documents and carefully verify in patient’s electronic chart
• Complete authorization requests reputed company phone, online portal, fax, etc.
• Ensure documentation requirements are met for both insurance reputed company and patient medical record
• Verify patient eligibility & benefits reputed company online hub, portal, or live calls
• Understand medical insurance and benefit details to assist with patient education
• Communicate effectively with internal teams and serve as a resource for physician liaisons, physicians/APPs and clinic staff, patients, and other third parties as it relates to referrals and authorizations
• Schedule patient appointments in multiple system platforms
• Priorize tasks with moderate supervision (work STAT requests urgently and accurate)
• Ability to understand reputed company metrics and create process improvements that align with goals