Position Summary

Primary focus to centrally manager referrals across the organization.  Ensure timely and accurate processing of referrals, improve coordinator of care, and reduce delays in patient access. This position will have a direct positive impact on revenue integrity by ensuring that all required referrals are secured prior to the patient’s arrival, thereby reducing the risk of claim denials and lost revenue. This position will cross-train to support the pre-authorization team, providing flexibility to address the volume of authorization requirements and strengthening overall department efficiency.

Primary Duties

• Insurance Verification: Contacts health insurance companies to verify coverage, obtain pre-authorizations, and pre-certify specific procedures.
• Appointment Coordination: Schedules and tracks patient referrals with external specialists, diagnostic facilities, and community resource organizations.
• Medical Record Management: Updates Electronic Health Record (EHR) systems with patient clinical background, referral documentation, and test results.
• Patient Communication: Informs patients about their referral status, appointment details, preparation requirements, and any out-of-pocket cost.

Qualifications/Specifications

• Education: High School diploma or GED required.
• Licensure/Certification: None required.
• Experience: Minimum of three years’ experience in a related field (i.e., patient admissions, registration, insurance verification). Previous healthcare experience preferred.