Primary Care Referral Coordinator

MAXhealth•Sarasota, FL

2d•Hybrid

About The Position

Busy Primary Care practices seek Referral Specialist to manage all referrals for our patients. The Referral Specialist is responsible for ensuring that the patient's insurance allows them to access the services of the health care provider. This position supports our Primary Care Physicians to ensure we refer our patients to the best network and services needed. This position is multi-faceted and allows interaction with our Multidisciplinary team. This position requires organization as this is time sensitive daily duties that require excellent communication, professionalism, and attention to detail. If you have the qualifications and are looking for a hybrid position, apply and we will contact you immediately if you qualify! Candidates must reside in the state of Florida with remote flexibility but also willing to travel or work from office occasionally. Pay on average starts at $19/hour with flexibility based on qualifications and experience. Bilingual English/Spanish candidates preferred but not required.

Requirements

Candidates must reside in the state of Florida
Bilingual English/Spanish candidates preferred but not required.

Nice To Haves

2 years' experience working as a Referral Coordinator in a Primary Care Office
Familiarity with value-based care and Medicare Advantage insurance including vendor and capitation rules. (Humana Gold Plus, Careplus, WellCare, Freedom, Optimum, United Health Care Medicare, Devoted, Aetna Medicare, etc)

Responsibilities

Utilization management activities include coordinate timely approval of referrals, coordinate efficiency of referral department, collects medical information in order to determine appropriate use of services.
Monitoring quality of care that correlates with patients benefit plan and appropriate contracted providers.
Assists in strategies that will improve workflow, appropriateness, and quality outcomes of care by working across teams to accomplish goals.
Initiate direct communication with health care providers to obtain complete and accurate information.
Acting as a liaison between insurance, healthcare providers, and the department to ensure required referrals have been processed correctly for medical specialty visits
Accurately chart all information in EHR/EMR
Provide coverage for other areas/ departments as needed
Additional responsibilities as deemed necessary