Established Referrals & Verification of Benefits (VOB) Coordinator

Job Description

Job Description

Description:

Established Referrals & Verification of Benefits (VOB) Coordinator

Epic Pain Management |San Antonio, TX

Established Referrals & Verification of Benefits (VOB) Coordinator

Full-Time | Monday–Friday, 8:00 AM–5:00 PM

We are seeking a reliable, organized, and detail-oriented Established Referrals & Verification of Benefits (VOB) Coordinator to join our team at Epic Pain Management's New Braunfels location.

This position is responsible for processing established patient referrals, verifying insurance eligibility and benefits, tracking authorized visits, and ensuring all necessary referral and insurance requirements are completed before scheduled appointments.

The ideal candidate will have experience with medical insurance verification, referral processing, insurance payer portals, and patient scheduling. Strong attention to detail, excellent communication skills, and the ability to manage multiple responsibilities in a fast-paced medical office are essential.

At Epic Pain Management, every patient interaction matters. Our referral and verification team plays an important role in ensuring patients receive timely care while minimizing scheduling delays, insurance issues, and unnecessary disruptions.

As an Established Referrals & VOB Coordinator, you will work closely with patients, Primary Care Provider (PCP) offices, insurance carriers, front desk personnel, and other departments to support accurate referral processing and insurance verification.

Benefits include:

• PTO, paid holidays & 401(k) with 4% employer match
• 80% employer-paid medical insurance for employees, plus optional low-cost dental, vision, and family plans
• Pet insurance, legal insurance, identity theft protection, travel insurance, and employee discount programs

The Established Referrals & Verification of Benefits Coordinator is responsible for reviewing upcoming patient appointments to ensure all required referrals, insurance eligibility, and benefit information are verified before the date of service.

This position requires knowledge of insurance referral requirements, prior authorizations, authorized visit limits, copays, coinsurance, deductibles, and out-of-pocket responsibilities.

The coordinator will also communicate with PCP offices to request additional referrals, follow up on outstanding authorizations, process applicable Veterans Affairs (VA) referral requests, and document verified patient financial responsibilities for front desk collection.

This role requires strong multitasking skills, as the coordinator will also assist with incoming telephone calls, patient questions, referral follow-up, and scheduling coordination.

• Review established patient schedules to identify referral requirements before appointments
• Process established patient referrals according to insurance payer requirements and company procedures
• Determine whether insurance plans require referrals, prior authorizations, or additional documentation
• Verify referral effective dates, expiration dates, approved services, and authorized visits
• Track the number of approved and remaining visits for applicable patients
• Identify missing, expired, incomplete, or exhausted referrals
• Request additional referrals or authorized visits from Primary Care Provider (PCP) offices
• Contact PCP offices through phone, fax, or approved electronic systems
• Follow up on outstanding referral requests until completed
• Verify that referrals match the appropriate provider, location, and scheduled service
• Maintain accurate referral documentation and status updates
• Utilize insurance payer portals to research referral and authorization information

• Verify patient insurance eligibility and active coverage before scheduled appointments
• Confirm insurance coverage for the applicable date of service
• Identify patient copays, coinsurance, deductibles, and out-of-pocket responsibilities
• Review benefit information applicable to scheduled services
• Utilize insurance payer portals and contact insurance carriers to verify benefits
• Document verified insurance information accurately within the Electronic Medical Record (EMR)
• Enter patient financial responsibility information into appointment notes for front desk collection
• Identify inactive insurance coverage, missing insurance cards, and outdated patient information
• Contact patients to obtain updated insurance information when necessary
• Reverify insurance eligibility after updated information is received
• Communicate insurance discrepancies to the appropriate department
• Maintain accurate and timely verification documentation

• Review Veterans Affairs (VA) referrals for approved services, authorized visits, and expiration dates
• Prepare and submit VA Request for Services (RFS) forms when additional visits are needed
• Include required supporting documentation with VA requests
• Track outstanding VA referral requests and follow up on authorization status
• Document VA referral information and follow-up activity accurately
• Communicate unresolved VA referral concerns to the appropriate supervisor

• Contact patients regarding missing referrals, inactive insurance, or incomplete documentation
• Explain referral requirements and insurance-related scheduling concerns professionally
• Coordinate appointment rescheduling when required documentation cannot be obtained
• Verify that patients are scheduled with the appropriate provider and clinic location
• Communicate with front desk staff regarding referral status and patient financial responsibility
• Assist with resolving scheduling issues related to insurance or referral requirements
• Maintain accurate documentation of patient communications
• Help prevent unnecessary appointment cancellations or delays

• Answer incoming telephone calls and provide professional assistance to patients, PCP offices, and insurance carriers
• Respond to referral and benefit-related questions
• Manage incoming calls while completing referral and insurance verification responsibilities
• Return messages and follow up on outstanding requests
• Maintain organized referral queues, worklists, and insurance portal tasks
• Prioritize referrals and verification tasks based on upcoming appointment dates
• Collaborate with front desk, scheduling, authorization, billing, and clinical departments
• Identify recurring referral or insurance issues and communicate concerns to management

• Maintain accurate referral and benefit verification documentation within Athena/AthenaOne or other approved systems
• Document authorized visits, referral expiration dates, insurance status, and patient financial responsibilities
• Maintain organized records of referral requests and follow-up activity
• Follow established company procedures and insurance payer requirements
• Maintain patient confidentiality and comply with HIPAA requirements
• Demonstrate professionalism, accountability, accuracy, and attention to detail
• Participate in departmental meetings, training, and workflow improvement initiatives
• Maintain regular and reliable attendance and punctuality
• Perform other job-related duties as assigned by management

• High school diploma or GED required
• Previous experience with healthcare referrals, insurance verification, patient access, or medical scheduling preferred
• Two or more years of experience in medical referrals or Verification of Benefits preferred
• Strong understanding of insurance eligibility and benefit verification
• Knowledge of referral requirements and prior authorization processes
• Experience verifying copays, coinsurance, deductibles, and out-of-pocket responsibilities
• Ability to identify authorized visit limits, referral effective dates, and expiration dates
• Experience navigating insurance payer portals
• Ability to communicate with insurance carriers and PCP offices
• Experience processing established patient referrals preferred
• Experience with VA referrals and Request for Services (RFS) forms preferred
• Experience with Athenahealth/AthenaOne or comparable EMR systems preferred
• Previous Pain Management or specialty healthcare experience preferred
• Strong organizational, time-management, and multitasking skills
• Excellent attention to detail and documentation accuracy
• Strong verbal and written communication skills
• Excellent customer service and problem-solving abilities
• Ability to manage multiple referrals, insurance verifications, telephone calls, and deadlines simultaneously
• Ability to work effectively in a fast-paced, high-volume medical environment
• Ability to maintain patient confidentiality and comply with HIPAA requirements
• Bilingual in English and Spanish preferred
• Dependable, adaptable, and professional
• Must be available to work Monday through Friday, 8:00 AM–5:00 PM
• Regular and reliable attendance and punctuality are essential functions of this position