Referral Coordinator

CenterPlace Health, Inc.; North Port (FL); On-site; USD 40,000 - 50,000; Full time

Job summary

CenterPlace Health, Inc. in Florida is seeking a Referral Coordinator to manage specialty referrals, external scans, and x-rays for patients as directed by the primary care physician.

You will review referrals in the EHR, verify insurance coverage, contact providers and insurers, and ensure timely authorization with proper documentation. The role requires strong communication, accuracy, and coordination with care teams to close referral loops efficiently.

Qualifications

• High School diploma or GED.
• Experience with third-party vendors for referrals (Availity, Medicare/Medicaid).
• Strong oral and written communication.
• Ability to interact with physicians, patients, and staff.
• Proficient use of EHR and Office 365.

Responsibilities

• Review referrals completed by providers within the EHR, verify accuracy, and contact providers for information.
• Contact the insurance company to verify patient coverage.
• Send/fax referrals and patient notes to the appropriate specialty office or radiology center.
• Obtain prior authorization and document authorization numbers in the medical record.
• Coordinate peer-to-peer review with providers and insurance representatives when necessary.
• Provide patients with directions and update providers on STAT referral issues.

Skills

Communication skills

Typing skills

Patient interaction

Attention to detail

Education

High School diploma or GED

Tools

EHR system

Office 365

Outlook

Excel

Job description

CenterPlace Health believes that each employee makes a significant contribution to our success. That contributionshould not be limited by the assigned responsibilities. Therefore, this position description is designed to highlight theprimary duties, qualifications, and scope of the position, but not limit the incumbent nor the Company to only the workidentified. It is our expectation that each employee will offer his/her full capabilities wherever and whenever necessaryto ensure the success of our endeavors.SUMMARY:The Referral Coordinator is responsible for coordinating specialty care or outside scans, and x-rays for patients in needof external consultation as requested by the primary care physician. The Referral Coordinator researches referralrequests in a timely manner and ensures it meets medical necessity with thorough documentation to obtain priorauthorization. The referral Coordinator also prioritizes all urgent referrals and makes sure the loop is closed in a timelymanner.ESSENTIAL FUNCTIONS:General Duties:• Review referrals completed by providers within the EHR, open referral and verify procedure for accuracy,contact provider for additional information, if needed.• Contact the insurance company and verify patient insurance coverage.• Send/fax referral and patient notes to appropriate specialty office or radiology center.• Obtain authorization from the insurance company, send/fax patient requested notes to the insurance company.• Coordinate peer to peer review with provider and insurance medical representative when necessary.• Note procedure authorization number on medical record• Communicate with the referral facility authorization documentation• Provide patients with directions to location when needed• Updating provider on any STAT referral issues• Discussing with provider if any issues come up on a referral. For example, patient has no insurance and can’tget to referral appointment due to ride issues. Communication and documentation are keyElectronic Health Record (EHR):• Accurately and efficiently enters documentation into the EHR.• Ensures necessary patient referral information is available in the EHR prior to visit.• Demonstrates basic understanding of the EHRCover PSR Clerical Duties as needed:• Performs clerical duties as directed by office manager.• Schedule’s appointments.• Takes phone messages.• Scan’s information into the Electronic Health Record.Performs patient registration functions.• Workflow dashboard (working in referral Bucket)• Order entry and workflowManage work queues:• Performs other duties as assigned• Completes all required trainings and attends meetings as assigned.• Protects/observes patient confidentiality per policies and procedures.• Assures translation, as needed, for non-English speaking patients.• Recognizes and responds appropriately to violent/abusive situations, bomb threats, fire, and emergencysituations.Please note this position requires a background check to be completed. For details, please follow the link below:FL Clearinghouse | Florida Agency for Health Care AdministrationMINIMUM QUALIFICATIONS: (EXPERIENCE/SKILLS/ABILITIES/EDUCATION/CERTIFICATIONS):• High School diploma or GED equivalent.• Some knowledge of/experience working with third party vendors to complete referral/authorizations (Availity,Medicare, Medicaid websites, etc.)• Demonstrates good oral and written communication skills.• Ability to effectively interact with physicians, patients, and other staff members• Effective use of the electronic health record• Possesses basic typing skills• Demonstrates knowledge of proper, safe, efficient usage of current office equipment/software.• Demonstrates knowledge and ability to use Office 365 programs including Outlook, Word, and Excel.PREFERRED QUALIFICATIONS: (EXPERIENCE/SKILLS/ABILITIES/EDUCATION/CERTIFICATIONS):• Preferred 1 year working in a medical office• Bilingual preferred