Care Coordination & Referral Specialist

WVU Medicine; Wheeling (WV); On-site; USD 35,000 - 52,000; Full time

Job summary

Wheeling Hospital is seeking a Referral Specialist to collect comprehensive patient information for triage, coordinate care across departments, and handle insurance verification and pre-certifications. The role also involves scheduling appointments, communicating care instructions, and maintaining accurate patient records.

The ideal candidate has at least 2 years of clinical or customer service experience, strong communication skills, and familiarity with registration and billing processes.

Qualifications

• High School Diploma or equivalent required.
• 2 years of clinical or customer service experience preferred or required depending on role.
• Strong communication and customer service skills essential.
• Basic understanding of medical terminology preferred.
• Familiarity with registration/billing processes and third-party payers helpful.

Responsibilities

• Capture complete patient information for medical triage.
• Identify urgent patients and coordinate appropriate care.
• Assist in pre-certification/pre-authorization processes.
• Obtain and transfer external medical records for review.
• Gather demographic, billing, and insurance information for registrations.
• Explain insurance requirements and patient financial responsibilities.
• Schedule appointments using the Epic system and coordinate with departments.
• Communicate effectively with patients and referring physicians about appointments and care steps.
• Assist in coordination of Workers' Compensation authorizations and related paperwork.
• Maintain accurate patient information in Cordata and other systems.

Education

High School Diploma or equivalent

Tools

Cordata software

Epic

Ruby-on-Line

Job description

Wheeling Hospital is seeking a Referral Specialist to collect comprehensive patient information for triage, coordinate care across departments, and handle insurance verification and pre-certifications. The role also involves scheduling appointments, communicating care instructions, and maintaining accurate patient records.

The ideal candidate has at least 2 years of clinical or customer service experience, strong communication skills, and familiarity with registration and billing processes.