Referral Coordinator

AdventHealth Medical Group West FL • Zephyrhills, FL

432d • $32,219 - $48,318

About The Position

The Referral Coordinator at AdventHealth Medical Group West Florida is responsible for managing referral requests, obtaining necessary physician approvals, and processing medical records related to referrals. This role involves scheduling appointments, maintaining positive relationships with physician offices and patients, and ensuring accurate communication regarding benefits and payments. The position emphasizes outstanding customer service and adherence to HIPAA guidelines while supporting the operational efficiency of the office.

Requirements

• Strong knowledge of insurance carrier plans and coverage benefits.
• Understanding of procedures, CPT codes, HCPCS, and ICD-10 codes.
• Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).
• Professional oral and written communication skills.
• Problem-solving and critical thinking skills.
• Ability to work in a team setting and independently.
• Ability to work under pressure with deadlines and prioritize tasks effectively.
• Attention to detail and ability to manage simultaneous assignments.

Nice To Haves

• Medical terminology knowledge and office background.
• Understanding of co-insurance, co-pays, and deductibles.

Responsibilities

• Receive and process referral requests from patients and physician offices.
• Obtain physician approval for referrals and process medical records requests.
• Schedule appointments with referrals as necessary.
• Develop and maintain positive relationships with physician offices, patients, and facilities.
• Convey accurate benefit and payment details for future visits.
• Ensure pre-certification and verification of benefits are obtained and documented prior to procedures.
• Make outgoing calls or use online resources to obtain pre-certification or authorization from insurance carriers.
• Contact patients or physician's offices for additional information prior to scheduling exams, following HIPAA guidelines.
• Schedule hospital admissions and outpatient procedures/tests, notifying patients of appointments and referral numbers the same day they are obtained.
• Respond to all referrals within one to two business days and notify relevant parties of any changes to the schedule.

Benefits

• Paid Days Off from Day One
• Career Development
• Health Insurance
• Dental Insurance
• Vision Insurance
• 401k
• Flexible Scheduling

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED