Referral Management Coordinator

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

📋 Description

• Process referrals for all ambulatory services, including internal, incoming, and external requests.

• Obtain prior authorizations as necessary.

• Schedule patient appointments efficiently.

• Manage both inbound and outbound phone communications.

• Discuss copayment, prepayment, and outstanding balance responsibilities with patients.

• Participate in the collection process at the point of service.

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

• Assess the urgency of referrals and address them promptly.

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

• Communicate with insurance companies to confirm that prior approval requirements are fulfilled.

• Present medical history, diagnoses, and prognosis to insurance representatives when needed to establish medical necessity.

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

⛳️ Requirements

• High School Diploma or GED.

• Minimum of 2 years of experience in medical referrals, healthcare, and/or prior authorization.

• Travel requirements: Never or Rarely.

🏝️ Benefits

• Comprehensive benefit offerings for eligible employees.