Referral Coordinator: Hoag Clinic Claims & Enrollment

Hoag • Costa Mesa, CA

5d

About The Position

The Referral Coordinator prepares clinical data for physician approval and obtains authorizations. This role acts as a liaison between the patient, medical assistant, physician, and Central Business Office, ensuring all referrals are completed. The coordinator processes authorizations for consults and procedures for both fee-for-service and managed care patients, and advises patients on the status of their authorization requests. This position supports the referral process for all physicians, nurse practitioners, and physician assistants, prioritizing based on urgency. The Referral Coordinator manages an internal log of referral status per protocols and documents information in systems, ensuring clear communication of direct and indirect referrals to manage patient expectations. Other duties as assigned.

Requirements

• Experience in outpatient health care system(s) including managed care
• High School diploma or equivalent

Nice To Haves

• Previous experience with TouchWorks Utilization Standards
• Trained in coding compliance

Responsibilities

• Prepares clinical data for physician approval and obtains authorizations.
• Acts as liaison between patient, medical assistant, physician, and Central Business Office.
• Ensures all referrals are completed.
• Processes authorization for consults and procedures on both fee-for-service as well as managed care patients.
• Advises the patient of receipt/denial of authorization requests.
• Supports referral process for all physicians, nurse practitioners, and physician assistants and prioritizes based on urgency.
• Manages internal log of referral status per protocols and documents in systems.
• Ensures the communication of direct and indirect referrals to manage patient expectations.
• Performs other duties as assigned.

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED