Referrals Out Coordinator

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 240,000 - 420,000; Full time

Job summary

CF Solutions Philippines Inc. is seeking a Referrals Out Coordinator to manage patient referrals to external specialists and networks. You will liaise with patients, providers, insurers, and networks to ensure timely processing of referrals and authorizations.

The role requires coordinating documents, verifying eligibility, and scheduling appointments while ensuring compliance with HIPAA and payer guidelines. Strong organization and communication skills are essential.

Qualifications

• Bachelor's degree in healthcare-related field preferred.
• 1–2 years of experience in medical office, clinic, hospital, or healthcare setting.
• Experience in referral coordination, insurance verification, medical scheduling, or prior authorization preferred.
• Strong knowledge of medical terminology and HIPAA regulations.
• Experience with EMR/EHR systems and Microsoft Office Suite.

Responsibilities

• Review and process outgoing referral orders submitted by healthcare providers.
• Gather and verify required clinical documentation including orders, chart notes, and records.
• Ensure referral requests are complete and accurate before submission.
• Verify patient insurance eligibility and benefits.
• Confirm network participation and identify in-network provider options.
• Ensure referrals comply with payer guidelines and requirements.
• Compile and submit clinical documentation to the Prior Authorization team.
• Monitor authorization status and follow up to support timely approvals.
• Send referral packets and documentation to external providers and facilities.
• Coordinate and schedule specialist appointments for patients.

Skills

Attention to detail

Communication skills

Organizational skills

Verbal communication

Written communication

Education

Bachelor's degree in healthcare-related field

Tools

EMR/EHR systems

Microsoft Office

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.