Referral Management Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage the processing of internal, incoming, and external referrals for all outpatient services.

• Secure prior authorizations for necessary procedures.

• Coordinate patient scheduling effectively.

• Handle both inbound and outbound phone communications.

• Discuss financial responsibilities, including copayments, prepayments, and any outstanding balances, with patients.

• Adhere to and consistently apply current standardized referral policies and workflows.

• Assess the urgency of referrals and address them in a timely manner.

• Ensure that complete demographic, insurance, and relevant clinical information is forwarded to referred specialists.

• Communicate with insurance companies to fulfill prior approval requirements.

• Provide insurance companies with medical history, diagnosis, prognosis, and other essential information to demonstrate medical necessity.

• Review referral specifics and expectations with both ordering providers and patients.

⛳️ Requirements

• A High School Diploma or GED is mandatory.

• A minimum of 2 years of experience in medical referrals, healthcare, and/or prior authorization is required.

• Experience with prior authorization processes is essential.

• Capability to manage internal, incoming, and external referrals for ambulatory services is necessary.

• Travel is not required or is very minimal.

🏝️ Benefits

• Comprehensive benefit offerings for eligible employees.