Referral Coordinator

Astrana Health, Inc.; Las Vegas (NV); On-site; USD 28,000 - 32,000; Full time

Job summary

Astrana Health, Inc. is seeking a Referral Coordinator in Las Vegas to support patients needing specialty referrals. You will submit prior authorizations and referrals through insurance portals, send referrals to specialists, and follow up to ensure timely appointments.

The role requires strong communication, familiarity with medical terminology, and proficiency in Microsoft Office and insurance databases. Join our Las Vegas team at our corporate office.

Qualifications

• High school diploma or equivalent required.
• At least 1 year of Call Center experience.
• Experience with Medical Terminology.
• Strong verbal and written communication skills; professional and courteous manner.
• Proficient in Microsoft Office applications and insurance eligibility databases; excellent data entry and typing skills.

Responsibilities

• Handle incoming calls efficiently.
• Identify patients’ needs, clarify information, 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 concerning referrals.
• Communicate with insurance companies to ensure requests adhere to coverage guidelines.
• Track referrals and provide follow-up as needed.
• Document referral activities in patient files.
• Maintain accurate and organized patient file documentation.
• Process Prior Authorization for medications, injections, biologics.

Skills

Call Center Experience

Verbal communication

Written communication

Data entry

Typing

Microsoft Office

Insurance eligibility database

Education

High school diploma or equivalent

Tools

Microsoft Office

Insurance eligibility database

E Clinical Works

Job description

Referral Coordinator

Department: Quality (UFT)

Employment Type: Full Time

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

Reporting To: Cristina Fernandez

Compensation: $20.00 - $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.

Qualifications

• 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 databaseExcellent 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.