Healthcare Referral & Authorization Coordinator

Community Health Of South Florida Inc; Hammocks (FL); On-site; USD 21,000 - 27,000; Full time

Job summary

Community Health Of South Florida Inc. is seeking a Referral Coordinator to manage referral authorizations and benefit inquiries for managed care enrollees.

You will process requests, enter data into the system, and coordinate with providers and insurance plans to ensure timely referrals. Qualifications include a high school diploma or GED, CMA/RMA preferred, CPR certification, and knowledge of Medicaid, HMO contracts, ICD10/CPT codes, and basic computer skills.

Qualifications

• High School diploma or GED required; Medical Assistant certification preferred.
• Two to three years in related area may substitute for MA certification.
• Certified Medical Assistant (CMA) or RMA desired; CPR current."

Responsibilities

• Process referral authorizations for emergency, specialty, and ancillary services.
• Ensure referral request forms are complete and processed timely.
• Enter referral authorizations into system for all enrolled clients.
• Complete a minimum of thirty referrals per day, front-end focus.
• Respond to inquiries regarding coverage, benefits, appointments, referrals.
• Schedule appointments with specialists and diagnostic centers.
• Maintain daily productivity log and ensure dates match referral letters.
• Participate in performance improvement activities and continuing education.
• Maintain licensure and certificates; assist transfer requests to CHI as needed.
• Maintain referral logs and monthly activity reports; request consultation reports as needed.

Skills

Medical Terminology

Keyboarding

Medicaid knowledge

HMO contracts

ICD10/CPT Codes

Basic computer skills

Typing 20–30 WPM

Bilingual (English/Spanish/Creole)

Education

High School Diploma or GED

Tools

EMR / Referral System

Microsoft Office

Job description

Community Health Of South Florida Inc. is seeking a Referral Coordinator to manage referral authorizations and benefit inquiries for managed care enrollees.

You will process requests, enter data into the system, and coordinate with providers and insurance plans to ensure timely referrals. Qualifications include a high school diploma or GED, CMA/RMA preferred, CPR certification, and knowledge of Medicaid, HMO contracts, ICD10/CPT codes, and basic computer skills.