Referral Coordinator

Plano Orthopedic And Sports Medicine Center Inc; Plano (TX); On-site; USD 23,000 - 26,000; Full time

Job summary

Plano Orthopedic & Sports Medicine Center is seeking a Referral Coordinator to manage the referral workflow, verify insurance requirements, and prevent delays in care. You will work closely with patients, referring providers, insurance carriers, and internal teams to document referrals accurately, maintain queues, and keep appointments on track.

This role requires organization, proactive communication, and a commitment to excellent customer service in a fast-paced outpatient setting.

Qualifications

• Experience in medical office/referral processes.
• Detail-oriented with strong organizational skills.
• Excellent customer service and written/verbal communication.
• Ability to manage high volume of patient information.
• Comfortable learning EHR and PM systems.

Responsibilities

• Process and manage incoming referral workflow.
• Schedule patients using practice management software.
• Work Comp intake assistance as needed.
• Verify insurance referral requirements and confirm referrals prior to appointment.
• Contact providers to request new or updated referrals.
• Verify referrals contain patient demographics, provider, diagnosis, dates, visits.
• Monitor referral expiration dates and remaining visits.
• Ensure referrals are valid for the correct provider and services.
• Document referral information in EMR/PM systems.
• Maintain referral queues and upcoming appointment lists.
• Follow up on pending referrals and escalate unresolved issues.
• Communicate with patients for additional information.
• Collaborate with scheduling, front desk, clinical, billing, and verification teams.

Skills

Customer service

Communication skills

Attention to detail

Organizational skills

Multitasking

Problem-solving

Tools

Practice management software

Electronic health record systems

Job description

About Plano Orthopedic & Sports Medicine Center

We believe our greatest strength is our people. We are committed to fostering a collaborative environment where employees are respected, supported, and encouraged to grow professionally. At Plano Orthopedic & Sports Medicine Center, we pride ourselves on awesome years of service to the community, delivering exceptional healthcare with a personal touch. Our culture is built on the core values of integrity, respect, compassion, service, a positive attitude, and teamwork. Here, you'll find more than a job, you'll find a supportive environment where your contributions truly matter.

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 **escalate** 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.

If you have medical office experience, enjoy working with insurance and referral processes, and take pride in making sure the details are handled correctly before a patient's visit, we encourage you to apply.

The pay range for this role is:

17 - 19 USD per hour (Plano Orthopedic & Sports Medicine center)