Referral Coordinator

hdmg; Lancaster (CA); Presencial; USD 32.000 - 43.000; Jornada completa

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

ICD-10 coding

CPT coding

Microsoft Office

Medical terminology

Written and verbal communication

Educación

High school diploma or equivalent

Descripción del empleo

High Desert Medical Group is looking for a full time Referral Coordinator for our Utilization Management department. This individual will help to ensure that all outside referrals have verified eligibility presented to Utilization Review in a timely manner for review, have scheduling arrangements, and are loaded and maintained on a computer.

Summary of Duties:

• 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.

The pay range for this position at commencement of employment is expected to be between $23.45-$31.30/hr, non-exempt; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

• 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.