Referral Coordinator - Medical Access & Authorization

Cape Fear Valley Health; Northern (KY); Hybrid; USD 38,000 - 56,000; Full time

Job summary

Cape Fear Valley Health is seeking a Referral Coordinator to obtain and verify demographic, clinical, financial, and insurance information for patients. The role involves verifying eligibility, obtaining pre-certifications, and coordinating referrals and authorizations to ensure proper documentation and care delivery.

The coordinator will communicate with patients, guarantors, specialists, and referring providers, while supporting adherence to HIPAA guidelines and maintaining accurate electronic

Qualifications

• High school diploma or equivalent required.
• Registered or Certified Medical Office Assistant or 2 years direct referral experience preferred.
• LPN background preferred.
• Proficiency in reading, writing, and speaking English; proficient with Microsoft software.

Responsibilities

• Maintains knowledge of processes for medical administrative personnel, including internal and external referrals.
• Performs insurance eligibility/benefit verification and ensures authorization matches tests/procedures.
• Validates medical necessity for Medicare and Non-Medicare cases for clinical and financial clearance.
• Obtains and prints orders, prep documentation, and documents in the EHR.

Skills

English proficiency

Microsoft Office

Verbal & written communication

Customer service

Problem solving

Education

High school diploma or equivalent

Registered or Certified Medical Office Assistant

Licensed Practical Nurse background

2 years referral experience

Tools

EHR software

Job description

Cape Fear Valley Health is seeking a Referral Coordinator to obtain and verify demographic, clinical, financial, and insurance information for patients. The role involves verifying eligibility, obtaining pre-certifications, and coordinating referrals and authorizations to ensure proper documentation and care delivery.

The coordinator will communicate with patients, guarantors, specialists, and referring providers, while supporting adherence to HIPAA guidelines and maintaining accurate electronic