Referral Coordinator

Primary Responsibilities 

• Acts as a developing subject matter resource for referral processes and supports team members with routine questions.  

• Serves as liaison between hospital departments, health plans, physicians, patients, vendors and other referral sources to facilitate referral processing.  

• Reviews referrals for completeness and accuracy and follows up for additional information when needed.  

• Verifies insurance coverage and obtains authorizations when required according to established processes.   

• Contacts physician offices as needed to obtain demographic information or related data.  

• Enters referrals, documents communications, actions and other data in system.  

• Escalates complex referral issues or authorization challenges to senior staff or leadership as appropriate.  

Minimum Qualifications 

• High school diploma or GED and 1+ year of customer service or healthcare administrative experience required; or any combination of education and experience which would provide an equivalent background. 

• Medical Assistant certificate / certification from an accredited training program required. 

• Strong knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.