Referral Coordinator

Plano Orthopedic & Sports Medicine Center; Plano (TX); On-site; USD 34,000 - 52,000; Full time

Job summary

Plano Orthopedic & Sports Medicine Center is seeking a Referral Coordinator to manage the referral process and ensure patients have valid insurance and PCP referrals prior to orthopedic services.

You will verify referral details, coordinate with physicians and insurers, and maintain accurate documentation to prevent delays in care. This role requires strong organizational skills and excellent patient communication, with a focus on accuracy and timely follow-ups.

Qualifications

• Experience coordinating referrals and understanding insurance requirements.
• Accurate documentation of referral information in EMR or practice management systems.
• Ability to manage a high volume of patient information with strong customer service.

Responsibilities

• Process and manage incoming referral workflow.
• Schedule patients using practice management software.
• Support Work Comp intake as needed.
• Verify insurance referral requirements and ensure referrals are received before appointments.
• Contact referring or PCP offices to request updated referrals when needed.
• Verify referrals include patient data, provider, diagnosis, dates, and visits.

Skills

Motivated

Organized

Customer service

Attention to detail

Prioritization

Communication skills

EHR proficiency

Insurance communications

Job description

About the role

The Referral Coordinator manages all aspects of the referral program in ensuring patients have the appropriate insurance and/or primary care physician (PCP) referrals in place prior to receiving specialty orthopedic services. This position works closely with patients, referring providers, insurance carriers, and internal team members to help prevent delays in care and avoid claim denials related to missing, expired, or incorrect referrals.

The ideal candidate is organized, proactive, comfortable working with insurance requirements, and able to manage a high volume of patient information while maintaining accuracy and excellent customer service. The position is responsible for establishing and standardizing systems and procedures including documenting the status of incoming referrals.

What you’ll do

• Process and manage incoming referral workflow
• Schedule patients using practice management software
• Work Comp intake assistance as needed
• Verify insurance referral requirements and confirm that required referrals are received prior
  to the patient’s scheduled appointment.
• Contact referring or primary care physician offices to request new, updated, or corrected referrals
  when necessary.
• Verify that referrals contain accurate information, including patient demographics, referring
  provider, orthopedic provider, diagnosis, effective dates, number of authorized visits, and other required information.
• Monitor referral expiration dates and remaining authorized visits to ensure continued coverage for
  follow-up care.
• Confirm that referrals are valid for the appropriate orthopedic provider and services being rendered.
• Accurately document referral information within the patient’s electronic medical record and/or
  practice management system.
• Maintain and work referral queues, reports, and upcoming appointment lists to identify outstanding
  referral needs.
• Follow up consistently on pending referrals and elevate unresolved issues when appropriate.
• Communicate with patients when additional information or action is required to obtain a valid referral.
• Work collaboratively with scheduling, front desk, clinical, billing, and insurance verification teams to resolve referral-related issues

Qualifications

• Highly motivated and organized
• Ability to manage in a fluid environment
• Excellent customer service and communication skills, both verbal and written
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities and follow through on outstanding items.
• Written and verbal communication skills.
• Comfortable communicating with patients, physician offices, and insurance carriers.
• Basic computer proficiency and ability to learn electronic health record and practice management systems.