Referral Coordinator Managed Care

Join Community Medical Group
Community Medical Group is seeking a detail-oriented, customer-focused, and highly organized Referral Intake Coordinator to join our Referral Management team.
As a Referral Intake Coordinator, you will serve as a critical point of contact for patients, provider offices, and internal teams, ensuring referrals are received, documented, and processed accurately and efficiently.
This role plays an essential part in helping patients access specialty care and services by coordinating referral intake, resolving documentation issues, managing urgent requests, and supporting a seamless patient experience. This is an excellent opportunity for someone who thrives in a fast-paced healthcare environment and has a strong background in referrals, managed care, and patient support.
Eligible employees receive a comprehensive benefits package that includes:

• 17 days of paid time off
• 11 paid holidays and one floating holiday
• Medical, dental, and vision coverage through UnitedHealthcare
• 401(k) retirement plan with company match
• Company-paid life insurance
• Opportunities for professional growth and career advancement

Answer and manage high-volume inbound referral calls from provider offices, patients, caregivers, and internal departments.
Provide professional guidance regarding referral status, required documentation, authorization requirements, and next steps.
Deliver an exceptional patient experience through effective communication and customer service.
Process urgent and STAT referrals to support timely patient access to care.
Validate referral completeness, including provider information, diagnosis codes, authorizations, and supporting clinical documentation.
Accurately enter and maintain referral information within the electronic medical record system.
Communicate with provider offices to obtain missing documentation and resolve referral discrepancies.
Escalate urgent or high-priority referrals in accordance with established protocols.
Document all calls, actions taken, and follow-up activities accurately and timely.
Meet productivity, quality, accuracy, and turnaround-time standards.
Maintain compliance with HIPAA, payer guidelines, and company policies and procedures.
Utilize referral management tools, payer portals, and electronic medical records to support daily operations.
Perform additional duties as assigned.
Qualifications

High school diploma or equivalent required.
Minimum of two (2) years of referral processing experience in a primary care, managed care, or value-based care setting.
Knowledge of medical terminology, CPT, HCPCS, and ICD coding.
Experience working with Electronic Medical Records (EMR), preferably eClinicalWorks (eCW).
Understanding of referral workflows, authorization requirements, insurance plans, and payer portals.
Proficiency with Microsoft Office applications, including Excel and Outlook.
Strong verbal and written communication skills.
Excellent attention to detail, organizational skills, and ability to manage multiple priorities.
Strong problem-solving and critical-thinking abilities.
Ability to work independently and collaboratively in a fast-paced environment.
Bilingual in English and Spanish or English and Creole preferred.