Referral Coordinator

Flexzo Ai; Town of Florida (NY); On-site; USD 22,000 - 26,000; Full time

Job summary

Flexzo Ai in Edgewater, Florida is hiring a Referral Coordinator to manage specialty referrals and ensure medical necessity with thorough documentation. This full-time role supports patients, primary care physicians, and external providers to streamline referral processes.

Candidates should have a high school diploma and at least 1 year in a medical office or healthcare setting; familiarity with scheduling, insurance verification, and patient registration is preferred.

Qualifications

• High school diploma or equivalent.
• 1+ year experience in a medical office or healthcare setting.
• Familiarity with scheduling systems, insurance verification, and patient registration processes preferred.

Responsibilities

• Processes patient referrals to specialty providers and facilities while adhering to protocol.
• Ensures that referrals are addressed in a timely manner, prioritizing urgent items appropriately.
• Reviews documentation from primary care provider or specialty provider to ensure medical necessity of the referral request.
• Prepares and submits Service Denials on referral requests that do not meet protocol. Reviews Service Denial with Director or Supervisor prior to submission to payor as needed.
• Prepares medical records to accompany referral, providing appropriate clinical information to specialist.
• Acts as a resource for patients or providers who have questions or problems relating to referrals.
• Maintains log of all referrals processed; submits log to District Manager or Supervisor monthly.
• Communicates internal and external referral request issues with District Manager or Supervisor in a timely manner.

Skills

Customer service

Patient-facing communication

Organizational skills

Attention to detail

Team-oriented

Education

High school diploma or equivalent

Tools

Scheduling systems

Insurance verification

Patient registration processes

Job description

Edgewater, Florida

Full-Time

$16-$19 per hour

A growing healthcare provider is seeking a Referral Coordinator.

The Referral Coordinator is responsible for coordinating specialty care for patients in need of external consultation as requested by the primary care physician. The Referral Coordinator researches referral requests in a timely manner and ensures it meets medical necessity with thorough documentation.

Key Responsibilities

• Processes patient referrals to specialty providers and facilities while adhering to protocol.
• Ensures that referrals are addressed in a timely manner, prioritizing urgent items appropriately.
• Reviews documentation from primary care provider or specialty provider to ensure medical necessity of the referral request.
• Prepares and submits Service Denials on referral requests that do not meet protocol. Reviews Service Denial with Director or Supervisor prior to submission to payor as needed.
• Prepares medical records to accompany referral, providing appropriate clinical information to specialist.
• Acts as a resource for patients or providers who have questions or problems relating to referrals.
• Maintains log of all referrals processed; submits log to District Manager or Supervisor monthly.
• Communicates internal and external referral request issues with District Manager or Supervisor in a timely manner.

Requirements

• High school diploma or equivalent
• 1+ year experience in a medical office or healthcare setting
• Familiarity with scheduling systems, insurance verification, and patient registration processes preferred

Skills & Competencies

• Strong customer service and patient-facing communication skills
• Excellent organizational and multitasking ability
• High attention to detail and accuracy, particularly with data entry and billing
• Ability to work in a fast-paced, high-volume environment
• Professional, reliable, and team-oriented approach

Key role in delivering an excellent patient experience

Opportunity to grow within healthcare administration