Healthcare Referral Navigator

Sanitas Medical Centers; Katy (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

Sanitas Medical Centers is seeking a Referral Coordinator to manage patient referrals, obtain prior authorizations, and schedule specialist appointments. You will ensure continuity of care by coordinating with providers, this role requires attention to regulatory requirements and patient privacy.

The position emphasizes accurate documentation, staff training, and effective communication with patients and health plans to streamline referrals and improve service delivery.

Qualifications

• Experience or familiarity with healthcare regulations and insurance requirements.
• Ability to review patient records and assess referral needs.
• Strong communication with providers, specialists and staff.
• Ability to verify insurance coverage and obtain necessary pre-authorizations.
• Accurate documentation and record keeping in electronic systems.
• Ability to explain referral processes to patients and provide support.
• Problem-solving skills to address referral challenges.
• Commitment to privacy and HIPAA compliance.

Responsibilities

• Train and educate staff on regulations and insurance requirements.
• Review patient records to assess referral needs and conditions.
• Collaborate with referring providers and specialists to coordinate care.
• Verify insurance coverage and obtain required pre-authorizations.
• Maintain accurate referral records and update the electronic system.
• Explain referral steps to patients and set expectations.
• Resolve issues that arise during the referral process.
• Ensure compliance with privacy regulations, including HIPAA.

Skills

Training and Education

Assessment and Evaluation

Communication and Liaison

Insurance Verification

Documentation

Patient Education

Problem-Solving

Compliance

Job description

Sanitas Medical Centers is seeking a Referral Coordinator to manage patient referrals, obtain prior authorizations, and schedule specialist appointments. You will ensure continuity of care by coordinating with providers, this role requires attention to regulatory requirements and patient privacy.

The position emphasizes accurate documentation, staff training, and effective communication with patients and health plans to streamline referrals and improve service delivery.