Referral Coordinator

Proactive MD; Romeo (MI); On-site; USD 25,000 - 39,000; Full time

Job summary

Proactive MD is seeking a Referral Coordinator to facilitate referrals, orders and prior authorizations across geographic regions and insurance plans. This role will independently complete prior authorizations and orders using EMR documentation, coordinating with the Provider, Patient Advocate, and Clinical Coordinator for seamless patient care.

Responsibilities include cross-training on related roles, answering clinic phones, and promptly notifying patients when referrals or authorizations are

Qualifications

• CMA preferred or 5+ years as a referral coordinator.
• 2+ years of experience in healthcare settings involving referrals, providers, or insurance.
• Current certification in Basic Life Support.
• Managed care insurance experience.
• Demonstrated problem solving skills.
• Ability to communicate effectively with patients and providers.
• Knowledge of insurance networks concepts and principles.
• Demonstrated ability to stay highly organized with time‑sensitive tasks.
• Knowledge of the healthcare industry and available patient resources.
• Knowledge of HIPAA confidentiality requirements.

Responsibilities

• Cross trained on Patients Advocate and Clinical Coordinator responsibilities.
• Provide clinical coverage by answering clinic phones and other duties as needed.
• Notify patient that referral/order or prior authorization has been completed and ask if there are barriers to completion.

Skills

CMA

Basic Life Support

Communication skills

HIPAA knowledge

Time management

Problem solving

Healthcare experience

Insurance networks knowledge

Education

CMA or 5+ years as referral coordinator

2+ years healthcare setting experience

Job description

People are a company's greatest resource, which is why caring for patients and keeping them healthy is so important. Proactive MD offers a comprehensive health management solution that extends well beyond the clinic walls. By engaging patients and offering them a personal relationship with a primary care provider, we can deliver measurably better outcomes, making people happier, healthier, and more productive while significantly lowering overall medical costs. We put patients' health first because amazing care yields amazing results.

JOB SUMMARY

The mission of the Referral Coordinator is to facilitate and ensure continuity in completing referrals/orders and prior authorizations requested by a provider. This role will understand the intricacies of providing high value referrals across geographic regions and different insurance plans. Works independently to complete prior authorizations and orders based on documentation in the EMR, accessing the provider when necessary and collaborates patient care with the Patient Advocate and Clinical Coordinator.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Will be cross trained on Patients Advocate and Clinical Coordinator responsibilities
• Provide clinical coverage by answering clinic phones and other duties as needed
• Notify patient that referral/order or prior authorization has been completed and ask if there are any barriers to completion of referral or accessing authorized service.

• Works with Director, Patient Care Navigation to ensure patients are receiving high quality low costs specialists/imaging. Reporting issues as they arise.
• Will adhere to all client specific responsibilities and duties.

REQUIRED KNOWLEDGE, SKILLS, & ABILITIES

Required:

• CMA preferred or 5 plus years as a referral coordinator
• 2+ years of experience working in healthcare setting with referral, provider and/or insurance experience
• Current certification in Basic Life Support
• Managed care insurance experience
• Demonstrated problem solving skills
• Ability to communicate effectively with patients and providers
• Knowledge of the concepts and principles of insurance networks
• Demonstrated ability to be highly organized around time sensitive tasks
• Knowledge of the healthcare industry and available patient resources
• Knowledge of HIPAA confidentiality requirements