Referral Navigator for Patient Care

Cano Health LLC; Miami (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Cano Health LLC is seeking a dedicated Referral Coordinator to support patient care coordination by managing insurance pre-verifications, referrals, and scheduling across clinics. You will liaise with patients, providers, and health plans to ensure timely, accurate handling of referrals and authorizations.

You will collaborate with care teams to educate patients about referrals, navigate barriers, and maintain thorough documentation in the EHR.

Qualifications

• High school diploma or GED.
• 1–2 years of experience in medical office, hospital, or clinical setting handling referrals.
• Working knowledge of medical terminology and insurance processes.
• Experience with scheduling systems, EHRs (e.g., eClinicalWorks), and insurance authorization procedures.
• BLS certification required; must be able to respond appropriately in emergencies.

Responsibilities

• Process outgoing referrals promptly based on provider orders.
• Review, validate, and document referral orders, input referrals and authorizations into the appropriate data systems.
• Schedule appointments with specialists or service providers, prioritizing high-quality, in-network, and cost-effective options.
• Track referral status, follow up on incomplete referrals, and ensure timely receipt of consultation reports.
• Close the referral loop by ensuring reports and documentation are routed to the appropriate provider.
• Educate patients on the referral process, insurance requirements, and expectations.
• Assist patients in overcoming logistical or administrative barriers (e.g., transportation, language, scheduling).
• Notify patients of appointment details and authorization status.
• Provide compassionate, professional support in person and over the phone, reinforcing a positive patient experience.
• Verify insurance eligibility and determine referral and authorization requirements.
• Obtain prior authorizations and approvals from health plans as needed.
• Collaborate with payers and specialists to expedite authorizations and respond to denials or appeals.
• Proactive schedule referrals related to quality metrics (HEDIS, STAR, QI).
• Support accurate documentation for risk adjustment and quality reporting.
• Track referral patterns and guide patients to in-network providers aligned with ACOs.
• Identify and address referral delays or barriers impacting outcomes.

Skills

Customer service

Time management

Bilingual English/Spanish

Microsoft Office

EHR navigation

Education

High school diploma or GED

Tools

eClinicalWorks (eCW)

Availity

Cano.Net

Workday

Oracle

Job description

Cano Health LLC is seeking a dedicated Referral Coordinator to support patient care coordination by managing insurance pre-verifications, referrals, and scheduling across clinics. You will liaise with patients, providers, and health plans to ensure timely, accurate handling of referrals and authorizations.

You will collaborate with care teams to educate patients about referrals, navigate barriers, and maintain thorough documentation in the EHR.