Referral Coordinator - Remote position

Responsible for the daily workflow of the Medical Management Department and the processing of referrals in an efficient manner.
Verifies enrollee eligibility and provider network status.
Interacts with provider offices to advise and educate on the referral process, assists with resolving issues, and obtains medical data.
Interacts well with co-workers, enrollees, and external customers.
Maintains enrollee confidentiality by following HIPAA rules and regulations, as well as internal compliance policies.
Receives and documents calls from providers via phone queue and addresses these in a professional manner using approved standard responses whenever applicable.
High School Diploma or general education degree (GED) and one to two years related experience and/or training; Knowledge of Microsoft Excel, word processing software, database software, and electronic medical record navigation.
Experience in data processing in a healthcare setting is a plus.
Community Care Plan is currently following a hybrid work schedule. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion.
In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.
The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants.