Referral Coordinator

Referral Coordinator

The Referral Coordinator manages all aspects of the referral program in ensuring patients have the appropriate insurance and/or primary care physician (PCP) referrals in place prior to receiving specialty orthopedic services. This position works closely with patients, referring providers, insurance carriers, and internal team members to help prevent delays in care and avoid claim denials related to missing, expired, or incorrect referrals.

The ideal candidate is organized, proactive, comfortable working with insurance requirements, and able to manage a high volume of patient information while maintaining accuracy and excellent customer service. The position is responsible for establishing and standardizing systems and procedures including documenting the status of incoming referrals.

What you'll do:

• Process and manage incoming referral workflow
• Schedule patients using practice management software
• Work Comp intake assistance as needed
• Verify insurance referral requirements and confirm that required referrals are received prior to the patient's scheduled appointment.
• Contact referring or primary care physician offices to request new, updated, or corrected referrals when necessary.
• Verify that referrals contain accurate information, including patient demographics, referring provider, orthopedic provider, diagnosis, effective dates, number of authorized visits, and other required information.
• Monitor referral expiration dates and remaining authorized visits to ensure continued coverage for follow-up care.
• Confirm that referrals are valid for the appropriate orthopedic provider and services being rendered.
• Accurately document referral information within the patient's electronic medical record and/or practice management system.
• Maintain and work referral queues, reports, and upcoming appointment lists to identify outstanding referral needs.
• Follow up consistently on pending referrals and escalate unresolved issues when appropriate.
• Communicate with patients when additional information or action is required to obtain a valid referral.
• Work collaboratively with scheduling, front desk, clinical, billing, and insurance verification teams to resolve referral-related issues

Qualifications:

• Highly motivated and organized
• Ability to manage in a fluid environment
• Excellent customer service and communication skills, both verbal and written
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities and follow through on outstanding items.
• Written and verbal communication skills.
• Comfortable communicating with patients, physician offices, and insurance carriers.
• Basic computer proficiency and ability to learn electronic health record and practice management systems.

If you have medical office experience, enjoy working with insurance and referral processes, and take pride in making sure the details are handled correctly before a patient's visit, we encourage you to apply.