Referral Coordinator

Upperline Health Inc; Chula Vista, Northern (CA, KY); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits

Weekday clinic hours

Interdisciplinary team

Job summary

Upperline Health is seeking a Referral Coordinator to manage patient referrals from start to finish, verify eligibility, coordinate referral appointments, and maintain accurate records in the EHR. You will serve as a liaison between patients, providers, and insurers, ensuring timely communication and resolution of any issues.

The ideal candidate will have 1–2 years in healthcare administration, experience with insurance verifications, and familiarity with EHR systems such as Athena.

Qualifications

• Minimum 1–2 years of experience in a healthcare administrative role, preferably in referrals or patient coordination.
• Familiarity with insurance verification and authorization processes is highly desirable.
• Experience with EHR systems such as Athena or similar platforms is a plus.

Responsibilities

• Receive and process patient referrals accurately and in a timely manner.
• Verify patient eligibility, insurance requirements, and authorization of proper CPT codes for referred services.
• Coordinate with referring and receiving providers to schedule appointments and ensure proper documentation and authorization of proper CPT codes.
• Serve as a liaison between patients, providers, and insurance companies.
• Provide patients with referral information, answer questions, and follow up to confirm appointments.
• Address and resolve any patient concerns regarding the referral process.
• Maintain accurate and up-to-date records of all referrals in the EHR system.
• Document communications with patients, insurance companies, and other healthcare providers.
• Ensure all referral requirements, authorizations, and compliance guidelines are met.
• Verify insurance details and requirements for each referral.
• Obtain necessary pre-authorizations or approvals from insurance companies and coordinate with billing departments as needed.
• Work closely with medical, administrative, and billing teams to ensure coordinated patient care and referral accuracy.
• Participate in team meetings to review referral trends, identify process improvements, and share best practices.

Skills

Organizational skills

Communication skills

Customer service

Attention to detail

Team collaboration

Education

High school diploma or equivalent

Associate or bachelor’s degree in healthcare administration/medical billing or related field preferred

Tools

Athena EHR

Microsoft Office

Job description

Upperline Health is the nation’s largest provider dedicated to lower extremity, wound and vascular care. Founded in 2017 with the ambitious goal of changing specialty care,Upperline Health delivers a more efficient path for patients to receive consistent and effective treatment for chronic illnesses.

Triage is temporary.

Treatment is transformative.

Upperline Health providers coordinate patients’ care among a team of physician specialists, nurse practitioners, care navigators, nutritionists, social workers, and pharmacists for integrated treatment that addresses patients’ immediate and long-term health needs.

We put patients at the center of value-based care.

WHY JOIN OUR TEAM?

• Competitive compensation
• Generous comprehensive benefit options include medical, dental, vision, 401K and PTO
• Work life balance – regular weekday clinic hours
• Supportive interdisciplinary team

About the Referral Coordinator Role

The Referral Coordinator is responsible for managing patient referrals and ensuring a seamless process from start to finish. This includes verifying patient eligibility, coordinating referral appointments, communicating effectively with patients and healthcare providers, and maintaining accurate records to support operational efficiency. The ideal candidate will excel in customer service, possess strong organizational skills, and demonstrate a commitment to providing excellent patient care.

Referral Management:

• Receive and process patient referrals accurately and in a timely manner.
• Verify patient eligibility, insurance requirements, and authorization of proper CPT codes for referred services.
• Coordinate with referring and receiving providers to schedule appointments and ensure proper documentation and authorization of proper CPT codes.
• Serve as a liaison between patients, providers, and insurance companies.
• Provide patients with referral information, answer questions, and follow up to confirm appointments.
• Address and resolve any patient concerns regarding the referral process.

Documentation and Record-Keeping:

• Maintain accurate and up-to-date records of all referrals in the electronic health record (EHR) system.
• Document communications with patients, insurance companies, and other healthcare providers.
• Ensure all referral requirements, authorizations, and compliance guidelines are met.

Insurance Coordination:

• Verify insurance details and requirements for each referral.
• Obtain necessary pre-authorizations or approvals from insurance companies and coordinate with billing departments as needed.
• Work closely with medical, administrative, and billing teams to ensure coordinated patient care and referral accuracy.
• Participate in team meetings to review referral trends, identify process improvements, and share best practices.

Referral Coordinator Qualifications:

Education:

• High school diploma or equivalent; associate or bachelor’s degree in healthcare administration, medical billing, or related field preferred.

Experience:

• Minimum 1-2 years of experience in a healthcare administrative role, preferably in referrals or patient coordination.
• Familiarity with insurance verification and authorization processes is highly desirable.
• Experience with EHR systems such as Athena or similar platforms is a plus.

Skills:

• Strong organizational and time management skills with an attention to detail.
• Excellent verbal and written communication skills.
• Ability to work effectively with diverse patient populations and handle sensitive information confidentially.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Customer-focused with a commitment to ensuring a positive patient experience.
• Detail-oriented, with strong problem-solving abilities.
• Team-oriented and collaborative.
• Ability to manage multiple tasks in a fast-paced environment.

Compensation

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience.

Job Type: Full-time

Equal Opportunity Employer
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