Coordinator Referrals - Specialty General Surgery

CHRISTUS Health; Mount Pleasant (TX); On-site; USD 42,000 - 52,000; Full time

Job summary

CHRISTUS Health in Mount Pleasant, TX seeks a referral coordinator to manage the entire referral workflow, including obtaining physician orders, insurance authorizations, and scheduling with in-network providers. The role supports accurate CPT/ICD-9 coding and communicates changes in insurance plans to staff and physicians.

Applicants should have a clinical background and 1–3 years of experience in referrals, with strong collaboration across physicians, nursing associates, and payors.

Qualifications

• Experience coordinating referrals or authorization processes.
• Knowledge of CPT and ICD-9 coding used for referrals.
• Ability to communicate with physicians, patients and payors clearly.

Responsibilities

• Coordinate the referral process from physician to payor.
• Schedule patient appointments with providers who accept the insurance.
• Notify patients of appointments and renewal authorizations with payors.
• Educate nursing staff and physicians about changes in insurance plans.

Skills

Referral coordination

Insurance authorizations

Education

High School Diploma or equivalent

Job description

Summary:

This position is responsible for coordinating the entire referral process (obtaining order from physician, obtaining insurance authorization from the insurance company/Payor, scheduling the appointment for the patient with a physician who accept the particular insurance, notifying the patient of the appointment, completing renewal authorizations with physicians office and Payor) for a 35 physician practice. Researches problem referral claims or requests for payment and corrects. Ensures physicians coding and Dx are appropriate for proper referral and coverage by insurance company. This position is also responsible for knowing various insurance plans and coverages for the patient to ensure proper payment. Responsible to teach nursing associates and physicians all changes within insurance plans for referral and authorization process. Must be up to date with all CPT and ICD-9 coding to process proper referral. Must have clinical background knowledge to appropriately support referral when communicating with insurance companies.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.

Requirements:

Education/Skills

• High School Diploma or equivalent required.

Experience

• 1 – 3 years of experience preferred.

Licenses, Registrations, or Certifications

• None required.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time