Referral Coordinator (Full Time)

Maui Medical Group, Inc. • Wailuku, HI

31d • $19

About The Position

The Referral Coordinator is our lead staff member responsible for receiving referral authorization requests from providers’ offices and obtaining from insurance companies the required authorizations and precertification based on current insurance guidelines. Coordinates and ensures information between the providers’ offices and insurance companies are accurate. Tracks referrals for timely completion.

Requirements

• High school diploma or equivalent and (2) years of medical experience in healthcare insurance administration.
• Possess working knowledge of medical and/or healthcare insurance terminology.
• Manages multiple tasks at the same time and works overtime as the need arises.
• Demonstrates computer literacy (i.e. EMR, referral tracking system, Excel, Microsoft word, etc.).
• Shows the ability to supervise department staff members.

Nice To Haves

• Demonstrates effective written and verbal communication skills.

Responsibilities

• Receives and coordinates referral authorization requests from providers’ offices. Verifies accuracy and completeness of referral request. Submits referrals, as required based on current insurance guidelines, to insurance companies for authorizations and precertification. Tracks and follows up with referral requests for timely completion. Records and forwards approved or denied requests to providers’ office. Works collaboratively with MMG leadership to direct referrals to preferred provider when deemed appropriate.
• Supervise Referral Clerk(s).
• Reviews and implements insurance guidelines. Educates as needed.
• Records, analyzes and reports statistical data for referral tracking system.
• Corresponds with or contacts all parties involved to include outside physicians, insurance companies and nursing personnel to complete the referral/authorization.
• All other miscellaneous responsibilities and duties as assigned.
• Demonstrates quality work, completes assignments on a timely basis, and makes decisions within limits of authority. Takes initiative in problem solving, maintains confidentiality of patient and company information, and interacts with patients, co-workers, and management in a courteous and respectful manner. Adheres to all company policies and procedures.
• Maintains attendance standards consistent with company policy.

What This Job Offers

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