Coordinator, Referrals

Cano Health LLC; Pompano Beach (FL); On-site; USD 36,000 - 54,000; Full time

Job summary

Cano Health LLC is seeking a Referral Coordinator to support care coordination, referrals, and authorizations within its primary care network. You will liaise with patients, providers, and health plans to ensure timely, accurate referrals and follow-up.

Responsibilities include handling referrals, educating patients, verifying insurance, and collaborating with the care team to optimize outcomes while maintaining HIPAA compliance and top-tier patient service.

Qualifications

• High school diploma or GED required; bilingual in English and Spanish preferred.
• 1–2 years experience in a medical office handling referrals.
• Experience with EHRs (eClinicalWorks) and insurance authorization procedures.
• BLS certification required; able to respond in emergencies.
• Proficient in Microsoft Office; familiar with Medicaid/Medicare portals and related systems.

Responsibilities

• Process referrals promptly, input authorizations, and schedule specialists.
• Educate patients on referral processes and insurance requirements; assist with barriers.
• Verify insurance eligibility and obtain prior authorizations as needed.
• Support quality metrics (HEDIS/STAR) and document referrals for risk adjustment.
• Document referral activities in the EHR and share updates with the care team.
• Collaborate with physicians, nurses, and care managers to coordinate care.
• Uphold HIPAA and secure patient data during referrals and communications.
• Provide clerical support and manage lobby/reception areas.

Skills

Bilingual English/Spanish

Medical terminology

EHR familiarity

Insurance processes

Microsoft Office

Education

High school diploma or GED

Tools

eClinicalWorks (eCW)

Availity

Cano.Net ticketing system

Workday

Oracle expense reporting

Job description

Job Summary

It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. The Referral Coordinator plays a vital role in supporting patient care coordination by managing insurance pre‑verifications, referral processing, appointment scheduling, and communication between patients, providers, and health plans. The individual ensures timely and accurate handling of all internal and external referrals, authorizations, and follow‑up activities, serving as a key liaison among clinics, specialists, and insurance carriers while upholding a patient‑centered and service‑oriented approach.

Essential Duties & Responsibilities

• Referral Management & Coordination:

  Process outgoing referrals promptly based on provider orders (e.g., specialty care, diagnostics, therapy). Review, validate, and document referral orders, input referrals and authorizations into the appropriate data systems. Schedule appointments with specialists or service providers, prioritizing in‑network, cost‑effective options. Track referral status, follow up on incomplete referrals, and ensure timely receipt of consultation reports. Close the referral loop by ensuring reports and documentation are routed to the appropriate provider.

• Patient Communication & Navigation:

  Educate patients on the referral process, insurance requirements, and expectations. Assist patients in overcoming logistical or administrative barriers (e.g., transportation, language, scheduling). Notify patients of appointment details and authorization status. Provide compassionate, professional support in person and over the phone, reinforcing a positive patient experience.

• Insurance & Authorization Processing:

  Verify insurance eligibility and determine referral and authorization requirements. Obtain prior authorizations and approvals from health plans as needed. Collaborate with payers and specialists to expedite authorizations and respond to denials or appeals.

• Value‑Based Care Alignment:

  Proactively schedule referrals related to key quality metrics, including HEDIS, STAR, and QI measures (e.g., mammograms, colonoscopies, diabetic eye exams). Support accurate and timely documentation to meet risk adjustment and quality reporting requirements. Track referral patterns and guide patients to in‑network or preferred providers aligned with ACOs and narrow network strategies. Identify, address, and elevate referral delays or barriers impacting clinical outcomes or contractual performance metrics.

• Administrative Support & Documentation:

  Maintain accurate documentation of all referral activities in the EHR. Log referral status, actions taken, and communications in a timely manner. Generate and distribute referral forms, notifications, and supporting documents.

• Care Team Collaboration:

  Work closely with physicians, nurses, medical assistants, and care managers to coordinate care. Participate in daily huddles to proactively address upcoming referral needs. Share referral status updates with clinical team members in real time.

• Compliance & Data Privacy:

  Uphold HIPAA guidelines and clinic protocols related to data handling and patient confidentiality. Ensure secure communication of patient records to external entities.

• Clinic Support & Environment:

  Provide clerical support to the clinical team, including managing lobby areas and assisting with PPE protocols. Collaborate with front desk and clinic staff to monitor scheduling and patient flow. Maintain a welcoming and organized patient experience environment.

Qualifications & Experience

• High school diploma or GED required; bilingual in English and Spanish preferred.
• Minimum 1–2 years of experience in a medical office, hospital, or clinical setting handling referrals.
• Working knowledge of medical terminology, insurance processes, scheduling systems, EHRs (e.g., eClinicalWorks), and insurance authorization procedures.
• BLS certification required; must be able to respond appropriately in emergencies.
• Proficient in Microsoft Office Suite (Excel, Word, Teams, PowerPoint). Familiarity with insurance portals (Medicaid, Medicare, commercial payers). Experience navigating multiple systems including eClinicalWorks (eCW), Availity, Cano.Net ticketing system, Workday, Oracle expense reporting, and health plan/diagnostic center portals.

Physical & Work Conditions

This position works under usual office conditions. The associate works at a personal computer and on the phone for extended periods, can stand, sit, walk, and occasionally climb. Must be able to work extended and flexible hours, weekends as needed, and lift up to 50 lbs. The associate may need to drive/travel 0‑25% to assigned clinics/territories.

EEO Statement

Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.