Referrals Out Coordinator

CF Solutions Philippines Inc.; Philippines; On-site; PHP 335,000 - 424,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking a Referral Out Coordinator to manage patient referrals to external specialists and healthcare providers, ensuring timely and accurate processing.

You will verify documentation, insurance eligibility, and network participation while coordinating scheduling and prior authorizations, contributing to efficient patient care.

Qualifications

• Bachelor's degree in a healthcare-related field
• 1–2 years experience in a medical office/healthcare setting
• Experience in referral coordination, insurance verification, medical scheduling, or prior authorization preferred
• Strong understanding of medical terminology, insurance verification processes, and HIPAA regulations
• Experience working with EMR/EHR systems
• Proficiency in Microsoft Office and healthcare-related software
• Excellent organizational skills with strong attention to detail
• Effective verbal and written communication skills

Responsibilities

• Review and process outgoing referral orders
• Gather and verify required clinical documentation
• Ensure referral requests are complete before submission
• Verify patient insurance eligibility and benefits
• Confirm specialist and facility network participation
• Ensure referrals comply with payer guidelines
• Submit clinical documentation to the Prior Authorization team
• Monitor authorization status and follow up as needed
• Send referral packets and medical documentation to external providers
• Coordinate and schedule specialist appointments

Skills

Referral coordination

Insurance verification

Medical scheduling

EMR/EHR literacy

HIPAA knowledge

Microsoft Office

Education

Bachelor's degree in healthcare

Tools

EMR/EHR software

Microsoft Office Suite

Job description

About the role

The Referrals Out Coordinator is responsible for managing the coordination of patient referrals to external specialists, facilities, and healthcare providers. This role serves as a liaison between patients, providers, insurance companies, and outside healthcare networks to ensure timely, accurate, and efficient referral processing.

Key responsibilities

• Review and process outgoing referral orders submitted by healthcare providers.

• Gather and verify all required clinical documentation, including provider orders, chart notes, and supporting medical records.

• Ensure referral requests are complete and accurate before submission.

• Verify patient insurance eligibility and benefits.

• Confirm specialist and facility network participation and identify in-network provider options.

• Ensure referrals comply with payer guidelines and requirements.

• Compile and submit required clinical documentation to the Prior Authorization team.

• Monitor authorization status and follow up as needed to support timely approvals.

• Send referral packets and medical documentation to external providers and facilities.

• Coordinate and schedule specialist appointments on behalf of patients.

About you

• Bachelor's degree in any healthcare-related course preferred (e.g., Healthcare Administration, Medical Technology, Nursing, Biology, Public Health, or other related fields).

• Minimum of 1 to 2 years of experience in a medical office, clinic, hospital, or healthcare setting.

• Previous experience in referral coordination, insurance verification, medical scheduling, or prior authorization is preferred.

• Strong understanding of medical terminology, insurance verification processes, and HIPAA regulations.

• Experience working with Electronic Medical Records (EMR/EHR) systems.

• Proficiency in Microsoft Office Suite and other healthcare-related software.

• Excellent organizational skills with strong attention to detail.

• Effective verbal and written communication skills.