Referral Coordination Specialist – Medical Utilization

hdmg; Lancaster (CA); Sur place; USD 32 000 - 43 000; Plein temps

Résumé du poste

High Desert Medical Group is seeking a full-time Referral Coordinator in the Utilization Management department to ensure referrals are verified, scheduled, and loaded accurately for review.

The role requires knowledge of CPT/ICD-10 coding, proficient Microsoft Office, and strong communication. You will handle patient notifications, coordination with providers, and tracking referrals to support efficient patient care.

Qualifications

• High School diploma or equivalent.
• One year experience in a medical office, including coding and claims, and dealing with the public, preferred.
• Knowledge in CPT/ICD-10 coding.
• Proficiency in Microsoft Office.
• Knowledge of medical terminology preferred.
• Excellent written and verbal communication skills.
• Ability to handle and prioritize tasks in order to meet all given deadlines and productivity goals.
• Ability to responsibly handle matters of a confidential nature.
• Ability to work in a multi-task, high-productive environment.

Responsabilités

• Present referral for approval to Utilization Review Committee. Notify Primary Care Provider of any changes or denials.
• Notify patients regarding denial and modifications of services.
• Notify patients of approved referrals and scheduling information.
• Code referrals according to ICD-10 CM/CPT codes.
• Input referral data and print authorization for all approved referrals.
• Assist patients in resolving questions/problems.
• Organize workload and workflow process in the department to ensure referrals are processed timely.
• Assist insurance companies regarding patient referrals.
• Assist primary care physician office on status of referrals.
• Perform other duties as assigned.

Connaissances

ICD-10 coding

CPT coding

Microsoft Office

Medical terminology

Written and verbal communication

Formation

High school diploma or equivalent

Description du poste

High Desert Medical Group is seeking a full-time Referral Coordinator in the Utilization Management department to ensure referrals are verified, scheduled, and loaded accurately for review.

The role requires knowledge of CPT/ICD-10 coding, proficient Microsoft Office, and strong communication. You will handle patient notifications, coordination with providers, and tracking referrals to support efficient patient care.