Referral Coordinator

Astrana Health, Inc.; Henderson (NV); On-site; USD 26,000 - 32,000; Full time

Job summary

Astrana Health, Inc. is seeking a Referral Coordinator to join our Billing - Central team at Las Vegas area office. You will manage specialty care referrals, submit prior authorizations, and ensure timely referrals to specialists while coordinating with patients and insurance portals.

You will handle incoming calls, verify information, and document all referral activities in patient files. Strong communication, data entry, and familiarity with insurance processes are essential for success in

Qualifications

• , High school diploma or equivalent required.
• 1 year of call center experience.
• Experience with Medical Terminology.
• Strong verbal and written communication skills.
• Proficient in Microsoft Office and insurance eligibility databases.
• Excellent data entry and typing skills.

Responsibilities

• Handle incoming calls efficiently.
• Identify patients’ needs, submit referrals via insurance portals, fax referrals, and follow up with patients.
• Provide courteous customer service regarding referral requests.
• Request consult notes from other providers as needed.
• Respond to patient inquiries about referrals.
• Communicate with insurance companies to ensure coverage guidelines.
• Track referrals and provide follow-up.
• Document referral activities in patient files.
• Maintain accurate patient file documentation.
• Process Prior Authorization for medications, injections, biologics.

Skills

Call Center Experience

Medical Terminology

Verbal and Written Communication

Typing

Data Entry

Education

High school diploma or equivalent

Tools

Microsoft Office

Insurance eligibility databases

Job description

Referral Coordinator

Department: Billing - Central

Employment Type: Full Time

Location: 8880 W Sunset Rd, Suite 320, Las Vegas NV 89148

Reporting To: Cristina Fernandez

Compensation: $19.00 - $23.00 / hour

Description

About the Role:

The Referral Coordinator is responsible for assisting patients who require specialty care referrals. The coordinator submits all prior authorizations and referrals through the proper insurance portals for approval. Responsible for sending out the referrals to the specialists and following up with the specialists and patents to ensure they are seen.

Our Values

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• Handle incoming calls efficiently.
• Responsible for identifying patients’ needs, clarifying information, submitting referrals via insurance portals, faxing out referrals and following up with the patient.
• Provide courteous customer service to patients regarding referral requests.
• Request consult notes from other providers as needed.
• Responds to all patient inquiries concerning their referrals.
• Communicate with insurance companies to ensure all requests adhere to guidelines of coverage.
• Track referrals and provide follow-up as needed.
• Document all referral activities on patient files for future reference.
• Maintain accurate and organized patient file documentation.
• Process Prior Authorization for Medications, Injections, Biologics.

Skills, Knowledge & Expertise

• High school diploma or equivalent required
• At least 1 year of Call Center Experience
• Experience with Medical Terminology
• Strong verbal and written communication skills; must be able to communicate in a professional and courteous manner
• Proficient in Microsoft Office applications and insurance eligibility database
• Excellent data entry and typing skills

Preferred Qualifications

• A minimum of 1-year previous experience for both Prior Authorization and Referrals preferred
• Knowledge of E Clinical Works
• Knowledge of managed care and medical insurance plans

Environmental Job Requirements and Working Conditions

• This position is located in our Las Vegas Corporate Office - 8880 W Sunset Rd, Suite 320, Las Vegas NV 89148.
• The base pay range for this role is $19 - $23 per hour. This salary range represents our national target range for this role.