Healthcare Referral Operations Specialist

Well Care Health; Raleigh (NC); On-site; USD 52,000 - 68,000; Full time

Job summary

Well Care Health in Raleigh, NC is seeking a Sales Support Specialist to oversee standardized regional referral coverage and referral-management for assigned branches. You will monitor referrals, validate SOC/ROC packets, and coordinate handoffs via Mosai, ensuring timely decisions and accurate documentation.

The role requires strong communication, healthcare familiarity, and proficiency with EMR and portal tools, supporting HIPAA compliance and collaborative teamwork with Account Executives and

Qualifications

• Two years of computer experience, preferably in healthcare.
• Experience in customer service, physician relations, referral intake, portal management, or medical insurance verification preferred.
• Proficient with Microsoft Office and Teams.
• Excellent communication and customer-service skills.

Responsibilities

• Monitors assigned referral portals and reviews referrals promptly.
• Applies standardized clinical, capacity, payer, service-area, and operational criteria to accept, decline, or escalate referrals within 15 minutes of receipt.
• Retrieves, reviews, and validates SOC and ROC referral packets, including demographic, insurance, physician, order, and face-to-face documentation.
• Completes referral handoffs through the Mosai platform and designated Portal Branch Teams channels according to procedures.
• Tracks referral disposition, missing documentation, escalations, and outstanding requirements through completion.
• Supports Home Health and Hospice referral coordination, including identification of potential non-billable Home Health discharges.

Skills

Communication

Customer service

Problem-solving

Time management

Microsoft Office

Microsoft Teams

Electronic Medical Records (EMR)

Referral portals

Education

High School Diploma or equivalent

Tools

Mosai platform

EMR systems

Job description

Well Care Health in Raleigh, NC is seeking a Sales Support Specialist to oversee standardized regional referral coverage and referral-management for assigned branches. You will monitor referrals, validate SOC/ROC packets, and coordinate handoffs via Mosai, ensuring timely decisions and accurate documentation.

The role requires strong communication, healthcare familiarity, and proficiency with EMR and portal tools, supporting HIPAA compliance and collaborative teamwork with Account Executives and