Referral Coordinator Clinical (CMA) - Care Coordination

Clinical Referral Coordinator

This position is on-site in Rockledge, Florida. Applicants must live close to the area. Certified Medical Assistant Cert is required.

Position Summary:

As a Clinical Referral Coordinator, you will play a vital role in our healthcare team, dedicated to delivering the highest quality of patient support. This position is responsible for the seamless coordination of provider specialty referrals from start to finish, ensuring exceptional customer experience and meticulous stewardship. Your key responsibilities include providing friendly, rapid, and accurate patient support, completing patient registration documentation, and assisting with various departmental projects and clerical duties. Your contributions will directly impact patient care and satisfaction, making you an essential part of our commitment to No Harm/Quality and outstanding service.

Primary Responsibilities:

• Receive and process referral requests from physicians, clinics, and other healthcare providers.
• Verify the accuracy and completeness of referral information, including patient demographics and insurance details.
• Ensure referrals are directed to the appropriate specialist or department based on medical necessity and provider availability.
• Schedule and coordinate appointments to align with patient and provider availability, minimizing wait times.
• Utilize in-depth knowledge of insurance policies, payor plans, par (participating) and non-par (non-participating) status, copays, and coinsurance to accurately process and manage patient referrals.
• Ensure all referrals are compliant with insurance requirements, verify patient eligibility, and maintain up-to-date records of insurance policies and payor information to support efficient and accurate referral processing.
• Confirm appointment details with patients and provide necessary instructions for their visits.
• Contact patients to inform them of referral status, appointment details, and any required pre-appointment preparations.
• Communicate with insurance companies to resolve any issues or discrepancies related to coverage and authorizations.
• Maintain accurate and up-to-date records of all referrals, appointments, and communications.
• Work closely with healthcare providers, medical assistants, and administrative staff to ensure smooth referral processes using clinical knowledge and training.
• Monitor referral and scheduling processes to identify areas for improvement.
• Other duties as assigned.

Work Experience:

Minimum Qualifications:

• Education: High School Diploma or equivalent.
• Work Experience: One (1) years' experience in a call center, customer service, or healthcare setting.
• Licensure: None
• Certification: Medical Assisting (MA) Certification in the State of Florida.
• Skills/Knowledge/Abilities:
• Extensive knowledge of healthcare terminology and abbreviations, previous healthcare experience is preferred.
• Compassionate and patient-focused approach to customer service.
• Strong organizational and multitasking abilities.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook) and comfortable using electronic health record (EHR) systems.
• Ability to work effectively in a fast-paced, high volume call center environment and meet performance metrics.
• Detail-oriented with a strong focus on accuracy and quality.

Preferred Qualifications:

• Work Experience: Three (3) years' experience in a call center, customer service, or healthcare environment.

Physical Requirements:

• Majority of time involves sitting or standing; occasional walking, bending, and stooping.
• Long periods of computer time or at workstation.
• Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
• May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise.
• Communicating with others to exchange information.
• Visual acuity and hand-eye coordination to perform tasks.
• May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.

Benefits:

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Schedule: Full-Time

Shift Times: 8:00am-6:00pm

Paygrade: PG-PG-PG-PG-PG-24

Health First Shared Services