Referral Coordinator

Position Summary

Our busy Orthopaedic and Sports Medicine practice is seeking a motivated self-directed hard working individual to manage all duties relating to appointment scheduling referrals and prior authorizations.

Hours: Monday through Friday, 40 hours per week, 8:30am to 5pm. (Training hours may vary between business hours 7am to 5pm, Monday through Friday.) 90 days of in office training required, with a potential hybrid schedule after the training period is completed.

Key Duties and Responsibilities

The key duties and responsibilities of the Referral Coordinator include, but are not limited to:

• Interacts professionally and effectively with clinicians, patients, referring providers, and insurance companies
• Verifies insurance eligibility and benefits, utilizing automated eligibility systems, payer portals, or telephone communication
• Maintains organized, detailed summaries of prior authorization/referral requests
• Manage incoming referrals from, but not limited to, other clinics, online requests, and obtain prior authorizations/referrals and schedules patients accordingly.
• Review scheduled appointments to ensure accuracy of insurance eligibility and referral requirements that align with Proliance’s insurance contracts.
• Maintain a working knowledge of health care plan requirements and health plan networks.
• Able to triage incoming calls and request documents needed from provider groups/patient for referral/authorization of services, questions, status updates.
• Complete duties and assist others as directed.
• Skill in organizing and reporting information that is accurate and complete.
• Consistency and timeliness in attendance.
• Composure in a fast-paced work environment.
• Function independently as well as a team player.

Essential Qualities:

• Essential Qualities: Effective communication skills
• Ability to work in high volume patient environment
• Strong attention to detail
• Self-directed/Motivated
• Experience verifying insurance utilizing online portals
• 1 -year experience in referral coordination/medical office required
• Next Gen AND Epic experience preferred
• Strong collaboration with our back-office, front office and business office teams.
• Phone, fax, MyChart and email correspondence.
• Must be punctual and have a reliable attendance record

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Work may be performed in an office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.