Medical Referral Coordinator

Job Description

Job Description

The Medical Referral Coordinator provides excellence in customer service to Neurology Care’s referral sources and their claimants/patients. Daily activities include inbound/outbound call handling, verifying insurance coverage, obtaining authorizations, securing and reviewing required documentation, processing orders, and completing follow-up. The Medical Referral Coordinator is responsible for facilitating patient referrals from primary to specialty care providers. 

Key Responsibilities:
Technical and Clinical Skills

• Serve as key liaison between patients, healthcare providers, and insurance companies to ensure seamless referrals and timely access to specialized care
• Coordinate medical referrals, authorizations, and scheduling
• Verify insurance benefits and obtain necessary approvals in compliance with reimbursement guidelines and customer rules
  *** In clinic reimbursement guidelines, “customer rules” typically refer to the provider’s obligations to patients and payers that ensure accurate billing, compliance, and fair payment. These rules are designed to protect both the clinic and the patient while meeting regulatory requirements.
• Identify and resolve referral-related issues
• Ensure all referral procedures comply with legal and medical standards
• Accurately completes and/or updates patient records 
• Processes orders in a timely and accurate manner per all applicable policies and procedures
• Notifies supervisor of issues that hinder process, unsatisfied customers, or any other significant negative customer service circumstance 
• Maintain patient confidentiality and data security as part of HIPAA compliance 
• Ensure all referral procedures comply with legal and medical standards 
• Accurately completes and/or updates patient records 
• Processes orders in a timely and accurate manner per all applicable policies and procedures 
• Notifies supervisor of issues that hinder process, unsatisfied customers, or any other significant negative customer service circumstance
• Maintain patient confidentiality and data security as part of HIPAA compliance 

Interpersonal and Communication Skills

• Communicate effectively with all patients; families; licensed personnel; insurance companies and third-party payers
• Advocate for patients interests by guiding them through complex neurological care pathways, resolving barriers, and providing timely information
• Collaborate with internal teams to ensure efficient workflow

Qualifications  

• 1-2 years of experience in medical referrals or related field
• Strong communication and organizational skills
• Proficiency in medical terminology and insurance processes
• Ability to work in a fast-paced environment
• Other duties as assigned

Benefits

• Medical, Dental, and Vision insurance
• Paid Time Off
• 401(k) Retirement Plan
• Great Work Environment