referral coordinator

Coastal Communities Physician Network

Under the direction of the Clinic Supervisor, this position is responsible to for verifying and interpreting member benefits for the health plans. The Referral Coordinator will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.
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1.1
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1.1 To be efficient in use of UM prior authorization systems utilized.
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1.2 Verify eligibility and benefit interpretation, via health plan and Medicare (CMS) websites.
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1.3 Be a resource for providers in regard to questions regarding network specialists.
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1.4 Ability to prepare authorizations and refer to appropriate providers/facilities and durable medical equipment (DME) companies.
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1.5 Guide and communicate with physician office, processing staff and other departments as needed to ensure collaboration and open discussion regarding all aspects of the referral process. Including responding to messages within the next business day.
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1.6 Review accuracy of pending referrals for ICD-10, CPT, HCPC code and provider selections made by the Authorization Clerk staff.
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1.7 Ensure referral data entry was accurately inputted into UM systems based on the referral and clinical information submitted.
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1.8 Have a complete understanding of established policy and procedure within Heritage provider network regarding the authorization processes.
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1.9 Maintaining assigned duties in an acceptable manner.
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1.10 Inform management on a daily basis when problems arise or when work falls behind.
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1.11Compile and document good faith attempts in obtaining medical records for each pending referral when there is lack of information.
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1.12 Compile clinical based guidelines, criteria and/or benefit information prior to forwarding referral to UM Managers for clinical review.
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1.13 Maintain filing in a timely manner.
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1.14 Provide Referral Coordinator coverage as needed.
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1.15 Process referral published on daily trending reports to maintain compliance with health plans and CMS timeframe regulations.
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1.16 Follow and have a complete understanding of the health plan and CMS regulations regarding timelines standards, benefit, and guideline hierarchy.
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1.17 Adaptable to regulation and necessary departmental procedure changes that affect UM prior authorization processes.
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1.18 Compliance with HIPM regulations and maintain patient confidentiality.
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1.19 Cultural and Linguistics training required annually.
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1.20 Other duties as assigned.
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<b>Requirements:</b><br>
8.1 High School graduate or GED certification required.
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8.2 One-year minimum experience working in a medical office environment (IPA or HMO preferred) with prior authorizations required.
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8.3 Knowledge of medical terminology required.
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8.4 Knowledge of HCPC, CPT and ICD-10, required.
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8.5 Proficient written and oral communication skills.
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8.6 Demonstrate proficiency in computer systems utilized.
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8.7 Ability to remain organized and able to manage competing priorities.
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8.8 Demonstrate good judgement.
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8.9 Demonstrate ability to take and follow through with delegated tasks and accountability.
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8.10Demonstrate resourcefulness in problem-solving.
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The pay range for this position at commencement of employment is expected to be reasonably between $24.27 and $28.55. However, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.
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If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
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<b>Compensation:</b> Between $24.27 and $28.55

Referral Coordinator

United Digestive

<div><div><b>GENERAL SUMMARY OF DUTIES:</b> Responsible for all duties revolving around the office, scheduling of patient appointments for procedures, follow-up office visits and ancillary services. Responsible for obtaining accurate documentation of patient information, management of physician schedules, coordination of referrals from Primary Care physicians and other specialists. Required to be cross-trained in all front office and patient service related functions in order to provide coverage as needed in various duties at office locations across the practice.</div><div>
</div><div><b>REPORTS TO: </b>Practice Manager</div><div>
</div><div><b>RESPONSIBILIITES</b><br>
Duties include but are not limited to:</div><ul><li><div>
Schedules, reschedules, and manages cancellations and no shows for patient office visits and procedures</div></li><li><div>
Maintains and updates current information on physicians&rsquo; schedules and endoscopy block time; schedules patients according to physician availability and preference</div></li><li><div>
Collects and records accurate patient information according to the UD Documentation Requirements</div></li><li><div>
Ensures all applicable procedures are scheduled in UD endoscopy suites; coordinates scheduling of procedures in hospital if necessary</div></li><li><div>
Ensures all applicable ancillary services are scheduled at UD</div></li><li><div>
Mails/Emails information packets to patients who are new to the practice</div></li><li><div>
Answers incoming calls in a timely and efficient manner; addresses questions regarding patient appointments and requests for information from referring providers</div></li><li><div>
Greets onsite patients in a prompt, pleasant, and helpful manner</div></li><li><div>
Accurately provides or counsels patients and/ or relatives with pertinent information regarding medical treatment or procedures; distributes or mails preps to patients if necessary</div></li><li><div>
Meets or exceeds quality and productivity standards as set by the Practice Manager</div></li><li><div>
Answers emails and voicemails and returns patient calls in a timely and efficient manner</div></li><li><div>
Completes requests for information from other UD staff and ensures that they are handled promptly and effectively to guarantee payment on patient accounts</div></li><li><div>
Abides by and promotes HIPAA compliance; maintains strictest confidentiality with regards to patient information</div></li><li><div>
Acts a liaison between the office and referring physician practices and hospitals</div></li><li><div>
Participates in staff meetings as directed by the Practice Manager</div></li><li><div>
Participates in marketing activities as directed by the Practice Manager</div></li><li><div>
Cross trains and performs other office functions including phone triage, check-in/check-out, scheduling, pre-certification, or medical records as directed by the Practice Manager</div></li><li><div>
Travels to office locations within the Metro area to provide coverage in various front office functions as directed by the Practice Manager and/or Regional Director of Operations</div></li><li><div>
Any other duties and/or special projects as assigned</div></li></ul><div>
</div><div><b>REQUIRED EDUCATION, SKILLS &amp; EXPERIENCE</b><br>
High School Diploma or GED required; Certified Medical Assistant preferred. 2-3 years of specialty clinic experience, gastroenterology experience preferred. Bilingual preferred, but not required. Staff member must be computer literate and able to operate healthcare system and multiple Microsoft Office applications.</div><div>
</div><div><b>ADDITIONAL SKILLS AND EXPERIENCE</b><br>
The Referral Coordinator must be able to:</div><ul><li><div>
Possesses the ability to deal with patients, visitors, co-workers, and physicians with courtesy and respect</div></li><li><div>
Displays a professional outgoing warm and helpful attitude</div></li><li><div>
Possesses compassion for dealing with people who are ill and need help</div></li><li><div>
Plan, prioritize, and complete multiple tasks as delegated by the Office Manager</div></li><li><div>
Work under pressure; assess, respond, and communicate issues in a timely manner</div></li><li><div>
Communicate clearly with patients and coworkers through the telephone, email, and in-person</div></li><li><div>
Interpret and apply clinical and non-clinical policies and procedures</div></li></ul><div>
</div><div><b>PHYSICAL/MENTAL/ENVIRONMENTAL DEMANDS</b><br>
Requires sitting and standing associated with a normal office environment; travel as business needs require</div></div>

M Zuhdi Jasser MD PC

<p><b>Job Overview</b><br/>We are seeking a dynamic and detail-oriented Referral Coordinator/Receptionist to join our healthcare team. In this vital role, you will serve as the first point of contact for patients and providers, ensuring smooth communication and efficient management of referrals, appointments, and medical records. Your energetic approach will help foster a welcoming environment while maintaining the highest standards of confidentiality and compliance. This position offers an exciting opportunity to contribute to quality patient care through excellent administrative support and coordination.</p><p><b>Responsibilities</b></p><ul><li>Greet patients and visitors warmly, providing exceptional customer service and guiding them through check-in procedures</li><li>Manage incoming calls, scheduling appointments, and directing inquiries with professionalism and enthusiasm</li><li>Coordinate referrals between providers, ensuring all necessary documentation is complete and accurately processed</li><li>Verify insurance coverage, perform insurance eligibility checks, and handle insurance verification processes efficiently</li><li>Maintain accurate medical records, including documentation of referrals, appointment details, and patient information in compliance with HIPAA regulations</li><li><b>Skills</b></li><li><b>Strong knowledge of managed care processes and insurance verification procedures</b></li><li>Prior experience in a medical or dental office setting is highly preferred</li><li>Familiarity with HIPAA regulations to ensure patient confidentiality at all times</li><li>Proficiency in medical terminology, medical records management, and medical coding practices</li><li>Excellent organizational skills with attention to detail in handling medical documentation and office tasks</li><li>Effective communication skills to interact confidently with patients, providers, insurance companies, and team membersJoin us in creating a positive impact on patient experiences through energetic support and meticulous coordination. We value your dedication to excellence in healthcare administration!</li></ul><p>Pay: $20.00 - $22.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

Referral Coordinator/Receptionist

Texas Spine and Pain

<p><b>Overview</b><br/>We are seeking a highly organized and proactive Front Office Coordinator to join our team. The role includes coordinating referrals and scheduling new appointments. This role is essential in ensuring the smooth operation of our office environment and providing exceptional customer service. The ideal candidate will possess strong administrative skills, attention to detail, and the ability to multitask effectively in a fast-paced setting.</p><p><b>Duties</b></p><ul><li>Serve as the first point of contact for patients, providing outstanding customer service and addressing inquiries promptly.</li><li>Manage phone systems, directing calls appropriately and taking messages when necessary.</li><li>Verify insurances, collect copays</li><li>Schedule appointments</li><li>Perform data entry tasks accurately and efficiently, maintaining up-to-date records.</li><li>Assist with proofreading documents to ensure clarity and professionalism in all communications.</li><li>Support office management functions, including organizing supplies, maintaining office equipment, and coordinating maintenance as needed.</li><li>Provide personal assistant support to executives or team members as required, including scheduling appointments and managing calendars.</li><li>Collaborate with team members to ensure effective communication and workflow within the office.</li></ul><p><b>Qualifications</b></p><ul><li>Proven experience in customer service or a similar role is preferred.</li><li>Strong organizational skills with the ability to manage multiple tasks simultaneously.</li><li>Proficiency in data entry with a keen eye for detail.</li><li>Familiarity with office management practices and procedures.</li><li>Experience using phone systems effectively in a professional setting.</li><li>Knowledge of eClinicalWorks is a plus but not mandatory; willingness to learn is essential.</li><li>Excellent proofreading skills with a strong command of grammar and punctuation.</li><li>Ability to work independently as well as part of a team in a dynamic environment.</li></ul><p>If you are an enthusiastic individual with a passion for organization and customer service, we encourage you to apply for this exciting opportunity as a Front Office Coordinator!</p><p>Job Type: Full-time</p><p>Pay: $13.00 - $22.00 per hour</p><p>Education:</p><ul><li>High school or equivalent (Required)</li></ul><p>Ability to Commute:</p><ul><li>Plano, TX 75025 (Required)</li></ul><p>Work Location: In person</p>

Front Office/ Referral Coordinator

The Brook Hospital - KMI

<div>Responsibilities:
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About The Brook Hospital - KMI:</b></div><div>
Since 1985, The Brook Hospitals have been providing quality mental health and addiction treatment services. The Brook Hospitals have two outstanding facilities located in Louisville, Kentucky. The Brook &ndash; KMI is a 110-bed hospital offering a full continuum of inpatient, extended care, residential, partial hospitalization and outpatient services for children, adolescents, and adults. The Brook Hospitals prides itself upon the fact that our patients are referred directly to us by local professionals and organizations: physicians, psychologists, social workers, employee assistance professionals, community mental health centers, hospitals, schools, courts, social service agencies and managed care organizations. These direct referrals and our high patient and family satisfaction rates are a reflection of our effectiveness in treating mental illness and addictions.</div><div></div><div><b><br>
Job Duties/Responsibilities:</b></div><div>
The <b><i>Intake Evaluation and Referral Coordinator</i></b> is responsible for answering all incoming intake calls and provide appropriate resolution. Conducts initial evaluations to determine an appropriate treatment level of care. Responsible for completing admission paperwork, including admission data entry. This position requires a person to work with minimal supervision. This position will work with all hospital units, business office, medical staff, medical records, utilization review, marketing, nursing, and data processing.</div><ul><li>
This opportunity is a full-time position from Monday - Friday of 40 hours per week with. The work hours are from 5:00am to 1:30pm.</li></ul><div></div><div><b><br>
Benefits Highlights:</b></div><ul><li><div>
Loan Forgiveness Program if offered.</div></li><li><div>
Challenging and rewarding work environment.</div></li><li><div>
Competitive Compensation &amp; Generous Paid Time Off.</div></li><li><div>
Excellent Medical, Dental, Vision and Prescription Drug Plans.</div></li><li><div>
401(K) with company match and discounted stock plan.</div></li><li><div>
Career development opportunities within UHS and its 300+ Subsidiaries! &middot; More information is available on our Benefits Guest Website: www.benefits.uhsguest.com</div></li></ul><div></div><div><b><br>
About U</b><b>niversal Health Services:</b></div><div>
One of the nation&rsquo;s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World&rsquo;s Most Admired Companies by Fortune; listed in Forbes ranking of America&rsquo;s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com</div>
Qualifications:
<ul><li><b>Education:</b><ul><li><b>
Required:</b> Master's Degree from an accredited school in the Behavioral Health field.</li></ul></li><li><b>
Experience:</b><ul><li><b>
Required:</b> 0 - 1 years of related experience.</li><li><b>
Peferred:</b> 1 - 3 years of related experience.</li></ul></li></ul><div></div><div><b><br>
EEO Statement</b></div><div>
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.</div><div></div><div><br>
We believe that diversity and inclusion among our teammates is critical to our success.</div><div></div><div><b><br>
Notice</b></div><div>
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.</div></div><div></div>

Intake Evaluation and Referral Coordinator

Paradigm Corp

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.
<br>We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.
<br>Watch this short video for a brief introduction to Paradigm.
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We are seeking a full-time, fully remote Orthotics DME Referral Care Coordinator to support a fast-paced, high-volume referral coordination department focused on DME orthotics and bracing (e.g., knee braces, ankle-foot orthoses/AFOs, wrist/hand braces, cervical collars, lumbar supports/LSOs, thoracic-lumbar-sacral orthoses/TLSOs). In this role, you’ll partner closely with referral sources, injured workers/patients, and orthotics/bracing providers to ensure timely authorization, ordering, status updates, and delivery confirmation—while maintaining accuracy, excellent customer service, and compliance. Candidates must have hands-on experience specific to DME orthotics and bracing and be comfortable managing multiple priorities in a production-driven environment. Schedule is Monday–Friday, 9:30 a.m.–6:00 p.m. Eastern Time.
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<b>Responsibilities:</b><br>
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<li>Receive DME referrals, communicate status and receipt of DME to referral sources. Ensure written authorization from payor source prior to delivery of equipment. Provide updates to referral sources, provider, and injured worker as well as confirmation of DME delivery. Work closely with referral sources, injured workers and DME providers to ensure appropriate DME is delivered in a specified timeframe. Follow up with injured workers and referral sources in a timely manner to ensure customer satisfaction.</li>
<li>Provide accurate, timely pricing to the Billing Department to ensure DME billing is accurate. Expand current list of DME providers, mindful to secure best possible pricing for equipment.</li>
<li>Coordinate specific work tasks with internal teams as needed to ensure smooth and efficient flow of information. Responsive to inquiries within given timeframes and within established policy. Appropriately follow up with supervisor, co-workers or residents regarding reported complaints, problems, and concerns.</li>
<li>Positively support the mission, values, and vision of Paradigm Corp. through effective communication with internal and external customers, serve as positive role model, demonstrate excellent customer service, and comply with all applicable regulatory requirements and Quality Assurance initiatives, including providing a work environment free from all illegal and discriminatory behavior and harassment, including sexual harassment.</li>
<li>Duties may include taking call on weekends, for which compensation will be provided.</li>
<li>Maintain reliable and predictable attendance during scheduled work hours.</li>
</ul>
<b>Qualifications:</b><br>
<ul>
<li>Education/Training: Some college credit and/or experience in a related discipline.</li>
<li>Experience: At least one (1) year of related experience (e.g., healthcare, DME, insurance, physician practice).</li>
<li>Skills: Excellent communication skills, verbal and written; Proficient in reading, grammar, and mathematics. Strong computer skills (e.g., Outlook, Excel, Word, Teams, proprietary software for which training will be provided); Accuracy and efficiency required. Excellent organizational, prioritization and multi-tasking skills. Knowledgeable of medical terminology.</li>
<li>Maintain Confidentiality of all data, including ensuring protection injured workers’ rights, Protected Health Information (PHI), employee, and operations data.</li>
<li>Compliance with all regulatory requirements, current laws and policies which protect workers from harassment and all illegal and discriminatory behavior. Comply with applicable Quality Assurance initiatives.</li>
<li>Complete requirements for required training, demonstrate acceptable attendance, and appropriate personal appearance.</li>
<li>Cooperate and work well together with all co-workers, ensuring all communication is professional and cordial; Plan, execute and complete job duties with minimal supervisory direction, utilizing appropriate sound judgment.</li>
<li>Equipment/Machinery Used: Standard office equipment including phones, calculators, copiers, scanners, fax, laptop/PC, copiers, various computer programs, mailing equipment, etc.</li>
</ul>
<b>Paradigm Benefits:</b><br>
<ul>
<li>Health and wellness– We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).</li>
<li>Financial incentives – Paradigm’s financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.</li>
<li>Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest.</li>
<li>Volunteer time– We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year.</li>
<li>Learning and development: One of Paradigm’s core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.</li>
</ul>
Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.
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Paradigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.
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We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
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As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster
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#LI-Remote

Orthotics DME Referral Care Coordinator

Tampa Family Health Centers

<div><div><p><b>Position Summary:</b> In accordance with the Center&rsquo;s policies and procedures, the referral Specialist functions under the direction of the referral Coordinator. This position is responsible for the planning implementation and follow-up of patient referrals generated by the primary care physician.</p><p><b>
 Essential Functions:</b></p><ul><li>Develops a comprehensive reference file of patient referral sources; serves as a resource person to other staff regarding the referral process</li><li>Utilize physician orders and medical assistant or nursing skills to prioritize patient referral needs</li><li>Schedule referral appointments timely</li><li>Follows assigned rotation schedule to specific centers to process referrals; responsible for managing referrals at rotation sites to prevent back-log</li><li>Initiates and assists in health education for patient and family</li><li>All routine referrals to be initiated within 10 working days; ASAP referrals initiated within 3 working days; urgent referrals to be initiated within 24 hours; mail appropriate copy of referral to third party payer</li><li>Thoroughly and accurately document referral efforts and outcomes; track referrals to ensure follow-up compliance</li><li>Keep accurate, complete and current referral logs</li><li>Collaborates with Case Managers and managed care providers to determine patient eligibility</li><li>Identifies referrals to be schedule by other staff in accordance with the referral degree of difficulty</li><li>Order referral forms from respective sources, as assigned</li><li>Effectively utilize EHR to assist in the comprehensive scheduling and follow-up of referrals</li><li>Alert appropriate care team members to challenges with referral funding</li><li>Communication of referral status to physician, as appropriate</li><li>Keep current in changes in managed care policies as related to the processing of referrals</li><li>Collaborate with Medical Social Worker to identify and address financial assistance needs of patients to access specialty care</li></ul><p><b>
 General Duties:</b></p><ul><li>Support the Mission, Vision and Values of Tampa Family Health Centers</li><li>Performs clerical duties for Referral Service department including:</li><li>Responds to calls in a timely manner</li><li>Assists clinical team with urgent referrals as needed</li><li>Assist internal and external customers with All referral needs</li><li>Interact with clinicals staff</li></ul><p><b>
Knowledge and Experience:</b></p><ul><li>Strong communication skills, both oral and written</li><li>Detailed -Oriented</li><li>Ability to multi-task in a fast-paced environment</li><li>Strong organization and prioritization skills</li><li>Minimum (1) years&rsquo; referral experience</li><li>Great work ethic</li></ul><p><b>
 Education, Certification Training and License:</b></p><ul><li>High School graduate or equivalent</li><li>Prefer experience with Microsoft applications</li><li>Prefer previous medical front desk (verification/eligibility)</li></ul></div></div>

Referral and Authorizations Specialist

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Referral and Authorizations Specialist