Referral Coordinator
About The Position
Primary Responsibilities Initiates and processes routing clinical referrals and authorization requests following established procedures. Serves as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources to support referral coordination. Reviews referrals for completeness and accuracy and follows up for additional information if necessary. Verifies insurance coverage and initiates pre-authorization requests in accordance with payer requirements and established workflows. Responds to inbound requests related to referral processing while meeting productivity and quality standards. Contacts physician offices as needed to obtain demographic information or related data. Enters referrals, documents communications, actions and related information in system. Escalates complex referral issues or authorization concerns to senior referral coordinators or leadership as appropriate. How will you make an impact & Requirements Minimum Qualifications High school diploma or GED and minimum of 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. Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred. Compensation: $18.00 to $27.00 Beware of fraudulent job postings: While Mosaic Health job advertisements may be found on many sites, our current openings page and its associated Workday account are the only places we accept applications for open roles. If you suspect a job post is fraudulent, please let us know at [email protected]. Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. Learn More about Mosaic Health Learn More about Millennium Physician Group Learn More about CareMore Health Learn More about Castlight Health Learn More about Vera Whole Health
Requirements
- High school diploma or GED and minimum of 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.
Nice To Haves
- Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.
Responsibilities
- Initiates and processes routing clinical referrals and authorization requests following established procedures.
- Serves as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources to support referral coordination.
- Reviews referrals for completeness and accuracy and follows up for additional information if necessary.
- Verifies insurance coverage and initiates pre-authorization requests in accordance with payer requirements and established workflows.
- Responds to inbound requests related to referral processing while meeting productivity and quality standards.
- Contacts physician offices as needed to obtain demographic information or related data.
- Enters referrals, documents communications, actions and related information in system.
- Escalates complex referral issues or authorization concerns to senior referral coordinators or leadership as appropriate.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
251-500 employees
