Referrals Coordinator

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The Referral and Scheduling Coordinator schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office. The Referral and Scheduling Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations and works on semi-routine assignments.

Key Responsibilities

• Process and manage referrals within the electronic medical record (EMR) in accordance with CenterWell PCO guidelines and Humana policies
• Review referral orders for completeness, accuracy, and required documentation prior to processing
• Assign referrals to appropriate in-network and out-of-network providers network standards
• Communicate with patients, provider offices, and internal clinical teams to coordinate referral needs and resolve issues
• Track referral status and follow up to support timely scheduling and completion of services in alignment with access and turnaround time expectations
• Answer inbound and outbound calls related to referral coordination while providing excellent customer service
• Document referral activity accurately and maintain compliance with HIPAA, PCO standards, and organizational policies
• Meet established productivity, quality, and referral turnaround time expectations
• Participate in daily huddles and team touchpoints to review priorities, workflows, and operational updates
• Provide education, guidance, and ongoing support to providers and center staff regarding referral workflows, PCO guidelines, and best practices
• Serve as a resource for referral-related questions to promote consistency, efficiency, and improved patient access to care
• Escalate complex, urgent, or non-standard referrals in accordance with PCO escalation pathways
• Support departmental initiatives focused on operational efficiency, compliance, and patient-centered care

Required Qualifications

• Minimum of 13 years of experience in a healthcare administrative, patient access, referral coordination, or call center role
• Strong data entry skills with high attention to detail
• Ability to manage multiple priorities in a fast-paced healthcare environment
• Professional written and verbal communication skills
• Demonstrated customer service skills with patients and provider partners

Preferred Qualifications

• Associate or bachelor's degree
• Experience working in a primary care, managed care, or Medicare Advantage environment
• Familiarity with medical terminology and referral workflows
• Experience using electronic medical records (Athena, eClinicalWorks, Epic, or similar systems)

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $38,000 - $45,800 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.