Referral Coordinator II

CareMore Health • West Covina, CA

2d • $23 - $35

About The Position

The Referral Coordinator II processes routine and moderately complex referrals, while supporting team productivity and referral workflow coordination.

Requirements

• High school diploma or GED and 1+ year of customer service or healthcare administrative experience required; or any combination of education and experience which would provide an equivalent background.
• Medical Assistant certificate / certification from an accredited training program required.
• Strong knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

Responsibilities

• Acts as a developing subject matter resource for referral processes and supports team members with routine questions.
• Serves as liaison between hospital departments, health plans, physicians, patients, vendors and other referral sources to facilitate referral processing.
• Reviews referrals for completeness and accuracy and follows up for additional information when needed.
• Verifies insurance coverage and obtains authorizations when required according to established processes.
• Contacts physician offices as needed to obtain demographic information or related data.
• Enters referrals, documents communications, actions and other data in system.
• Escalates complex referral issues or authorization challenges to senior staff or leadership as appropriate.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees