Primary Care Referral & Authorization Specialist

SFP Health Group; Kissimmee (FL); On-site; USD 42,000 - 60,000; Full time

Job summary

SFP Health Group in Kissimmee, FL is seeking a Referral Coordinator – Primary Care to manage referrals between providers, patients, and insurers. The role emphasizes accurate processing, timely scheduling, and coordination across care teams to maintain network integrity and patient satisfaction.

The ideal candidate will understand insurance verification, authorization processes, and navigate Medicare, Medicaid, Managed Care, Commercial, and Workers’ Compensation.

Qualifications

• High School Diploma or equivalent required.
• Certified Medical Assistant (CMA) preferred.
• Minimum 2 years of experience as a Referral Coordinator or similar role in a primary care setting.
• Experience with Medicare, Medicaid, Managed Care, Commercial, and Workers’ Compensation.
• Proficient in Excel and Availity.
• Knowledge of CPT, ICD-10, and medical terminology

Responsibilities

• Receive, review, process, and track referral requests to specialists.
• Schedule patient appointments with specialists.
• Follow up with patients and providers to ensure timely care.
• Maintain records in the EMR and referral tracking systems.
• Create and maintain the SFP Health Group Preferred Provider Network list.
• Verify insurance eligibility and obtain prior authorizations.
• Communicate with physicians, nurses, and care coordinators to obtain information.
• Ensure HIPAA compliance in all referral activities.

Skills

Interpersonal skills

Communication skills

Attention to detail

Patient-focused

Bilingual

Education

High School Diploma

Certified Medical Assistant (CMA) preferred

Tools

Excel

Availity

Athena

EMR systems

Job description

SFP Health Group in Kissimmee, FL is seeking a Referral Coordinator – Primary Care to manage referrals between providers, patients, and insurers. The role emphasizes accurate processing, timely scheduling, and coordination across care teams to maintain network integrity and patient satisfaction.

The ideal candidate will understand insurance verification, authorization processes, and navigate Medicare, Medicaid, Managed Care, Commercial, and Workers’ Compensation.