The Referral Coordinator works with the care team to process and track routine and urgent referrals to support specialty consults, follow-up care, and prior authorization when needed. This role also helps connect patients with appropriate medical, dental, and other community resources.
Responsibilities include:
- Verify insurance before completing referrals.
- Complete urgent referrals within 24 hours and non-urgent referrals within 5 business days.
- Assist with scheduling urgent referral appointments with referred specialists.
- Track referrals and document outstanding steps in the EMR until the order can be marked complete.
- Obtain prior authorization when required by the insurance carrier.
- Ensure consult notes and reports are received and documented within required timeframes.
- Communicate with care team members, patients, and specialist offices.
- Enter referral information into the EMR and patient management system.
- Fax referrals and supporting documentation to specialist offices.
- Maintain patient confidentiality and comply with privacy requirements.
- Support quality assurance activities and care coordination efforts.
Requirements & Qualifications
- High school diploma, GED, or equivalent.
- 1 year of customer service experience.
- Preferred: 1 year of experience in a medical office environment.
- Experience with electronic medical record systems.
- Some medical terminology knowledge.
- Basic understanding of HIPAA and PHI.
- Strong organizational, time management, and prioritization skills.
- Excellent written, verbal, and interpersonal communication skills.
- Ability to manage multiple tasks accurately in a high-volume environment.
- Ability to work independently and as part of a multidisciplinary team.
Location
Maryland, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago
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