Referrals Care Coordinator

Socket.dev; North Las Vegas (NV); On-site; USD 42,000 - 56,000; Full time

Job summary

Socket.dev is seeking a Referrals Care Coordinator to help patients access specialty care by processing referrals through insurance coverage and identifying affordable options for uninsured individuals. The role ensures referrals are completed, appointments with specialists are scheduled, and necessary notes are collected for the referral loop.

Ideal candidates will be bilingual (English/Spanish), with at least a year of referral processing experience and knowledge of health insurance plans.

Qualifications

• Fluency in English and Spanish is required.
• At least 1 year of experience processing referrals preferred.
• Strong knowledge of health insurance plans (HMO, PPO, Medicaid, Medicare) preferred.
• Basic Life Support (BLS) Certification required.

Responsibilities

• Use the EHR to track services, messages, and clinic workflows.
• Update eCW with lab results and referral details.
• Assist patients with scheduling and follow-up on referrals and appointments.
• Collaborate with providers, staff, and external organizations.
• Advocate for patients and improve satisfaction.

Skills

Bilingual English/Spanish

Referral processing experience

Health insurance knowledge

BLS Certification

Education

High School Diploma or equivalent

Medical Assistant program completion

Tools

EHR System

eCW System

Insurance Portals (HPN, Availity, Silver Summit, United Healthcare)

Job description

Description

JOB SUMMARY

The Referrals Care Coordinator is responsible for assisting patients in accessing specialty care by processing referrals through their insurance coverage or by identifying affordable options for uninsured individuals. The coordinator works to eliminate obstacles that may prevent patients from obtaining specialty care, such as cost, transportation, and appointment scheduling. They ensure that the referral process is completed by confirming that patients see the specialist and that the necessary medical consultation reports are obtained.

DUTIES AND RESPONSIBILITIES

Referrals Care Coordinator Duties

• Utilize the Electronic Health Record (EHR) system to track services, record patient messages, and contribute to clinic workflows.
• Update the Electronic Medical Record (eCW) system as necessary, including checking lab results and ensuring referral information is accurately entered.
• Help patients utilize resources, including scheduling, follows up on pending appointments and consultation notes.
• Ability to collaborate with providers, staff, and external organizations.
• Act as a patient advocate by responding empathetically to concerns and identifying opportunities to improve patient satisfaction.

Administrative Duties

• Relay detailed referral information to patients and provide accurate phone messages to providers and staff.
• Informs patient of steps needed for referral to be covered under insurance.
• Schedules for patient appointments with specialist providers as needed.
• Obtains consultation notes from the referral providers to close referral loop.
• Maintain a safe, secure, and healthy work environment by adhering to standards and legal regulations.
• Attends and actively participates in staff meetings.
• Performs all other duties as assigned.

Other Duties

• Promotes and demonstrates Hope values of: Gospel motivation, Prayer, Excellence, Stewardship, Patience, Thankfulness, Humility, Service, Dignity through Relationship and Hospitality and Joy
• Uphold Complies with HIPAA and protects patient information.
• The Referrals Care Coordinator ensures compliance with all 19 Health Resources and Services Administration (HRSA) Health Center Program Requirements.
• The Referrals Care Coordinator is also expected to actively participate in, and support quality improvement activities and the clinical practice team efforts emphasize the importance of the individual patient and putting the patient’s needs first.

Requirements

Qualifications

• Fluency in English and Spanish - required
• At least (1) year of experience processing referrals - preferred
• Strong knowledge of health insurance plans (HMO, PPO, Medicaid, Medicare) and insurance portals (HPN, Availity, Silver Summit, United Healthcare, etc.) – preferred
• Basic Life Support (BLS) Certification -required

Education

• High School Diploma or equivalent - required
• Successful completion of a Medical Assistant program from an accredited program or school -required

KEY COMPETENCIES FOR SUCCESS

• Faith to believe that Hope is a ministry of God, exemplifying the love of Christ, and held and directed by the Holy Spirit.
• Outstanding ability to build interpersonal relationships at all levels. Excellent communication skills, both written and verbal.
• Proven ability to establish, build, and nurture partnerships.
• Ability to think strategically and make good decisions under pressure.
• Proven leadership, teambuilding, and organizational skills.
• Proven ability to manage performance goals.
• Ability to analyze and process high volumes of information; multi-task, manage priorities; follow through.
• Ability to interact with people from all ethnic backgrounds, ages, and lifestyles.
• Ability to operate general office machinery (computers, calculators, copy/fax machine, telephones, etc.)

TYPICAL PHYSICAL DEMANDS

Occasional standing, walking, lifting, reaching, kneeling, bending, stooping, pushing, pulling, and lifting and/or moving up to 25 pounds. Frequent sitting. Manual dexterity. Good reading eyesight and vision for close work. Ability to communicate by speaking and hearing in person or on the phone. Ability to travel to various locations.