Referral Coordinator - Health Plan Authorizations

ADP, Inc.; Hammocks (FL); On-site; USD 21,000 - 26,000; Full time

Job summary

CHI Health operates as a referral coordinator role in Hammocks, Miami, FL, handling referral authorizations across managed care plans. Responsibilities include processing authorization requests, form accuracy, and daily productivity logging.

Strong knowledge of Medicaid, HMO contracts, ICD-10/CPT codes, and bilingual communication are valued, with CMA/RMA and CPR preferred. This is an equal opportunity, full-time clerical position offering hourly pay and opportunities for growth within CHI

Qualifications

• High school diploma or GED with CMA/RMA path preferred.
• Experience may substitute for CMA certification.
• CPR certification with American Heart Association preferred.
• State licensure/certification where applicable.

Responsibilities

• Process referral authorizations for emergency, specialty, and ancillary services.
• Ensure referral forms are complete and processed timely.
• Enter referrals in CHI computer systems for managed care enrollees.
• Handle approximately 30 referrals daily on the front end.
• Respond to inquiries about coverage and benefits from clients and providers.
• Schedule provider appointments and maintain logs for daily productivity.

Skills

Medical terminology

Typing 20-30 WPM

Medicaid knowledge

HMO contracts knowledge

ICD-10 & CPT knowledge

Managed care utilization knowledge

Basic computer skills

Bilingual English/Spanish

Bilingual English/Creole

Education

High School or GED

Medical Assistant Program (FL or any state)

CMA or RMA certification desired

CPR certification (AHA)

Job description

CHI Health operates as a referral coordinator role in Hammocks, Miami, FL, handling referral authorizations across managed care plans. Responsibilities include processing authorization requests, form accuracy, and daily productivity logging.

Strong knowledge of Medicaid, HMO contracts, ICD-10/CPT codes, and bilingual communication are valued, with CMA/RMA and CPR preferred. This is an equal opportunity, full-time clerical position offering hourly pay and opportunities for growth within CHI