Referrals Coordinator 1

CenterWellAsheville, NC
1d$38,000 - $45,800

About The Position

Become a part of our caring community and help us put health first The Referral Coordinator I supports CenterWell Senior Primary Care by coordinating and managing patient referrals to internal and external providers. This role ensures timely access to care, accurate documentation, and a positive patient experience while operating in alignment with CenterWell Primary Care Organization (PCO) guidelines, Humana policies, and established referral workflows. Key Responsibilities • Process and manage referrals within the electronic medical record (EMR) in accordance with CenterWell PCO guidelines and Humana policies • Review referral orders for completeness, accuracy, and required documentation prior to processing • Assign referrals to appropriate in-network and out-of-network providers network standards • Communicate with patients, provider offices, and internal clinical teams to coordinate referral needs and resolve issues • Track referral status and follow up to support timely scheduling and completion of services in alignment with access and turnaround time expectations • Answer inbound and outbound calls related to referral coordination while providing excellent customer service • Document referral activity accurately and maintain compliance with HIPAA, PCO standards, and organizational policies • Meet established productivity, quality, and referral turnaround time expectations • Participate in daily huddles and team touchpoints to review priorities, workflows, and operational updates • Provide education, guidance, and ongoing support to providers and center staff regarding referral workflows, PCO guidelines, and best practices • Serve as a resource for referral-related questions to promote consistency, efficiency, and improved patient access to care • Escalate complex, urgent, or non-standard referrals in accordance with PCO escalation pathways • Support departmental initiatives focused on operational efficiency, compliance, and patient-centered care Use your skills to make an impact

Requirements

  • Minimum of 1–3 years of experience in a healthcare administrative, patient access, referral coordination, or call center role
  • Strong data entry skills with high attention to detail
  • Ability to manage multiple priorities in a fast-paced healthcare environment
  • Professional written and verbal communication skills
  • Demonstrated customer service skills with patients and provider partners

Nice To Haves

  • Associate’s or Bachelor’s degree
  • Experience working in a primary care, managed care, or Medicare Advantage environment
  • Familiarity with medical terminology and referral workflows
  • Experience using electronic medical records (Athena, eClinicalWorks, Epic, or similar systems)

Responsibilities

  • Process and manage referrals within the electronic medical record (EMR) in accordance with CenterWell PCO guidelines and Humana policies
  • Review referral orders for completeness, accuracy, and required documentation prior to processing
  • Assign referrals to appropriate in-network and out-of-network providers network standards
  • Communicate with patients, provider offices, and internal clinical teams to coordinate referral needs and resolve issues
  • Track referral status and follow up to support timely scheduling and completion of services in alignment with access and turnaround time expectations
  • Answer inbound and outbound calls related to referral coordination while providing excellent customer service
  • Document referral activity accurately and maintain compliance with HIPAA, PCO standards, and organizational policies
  • Meet established productivity, quality, and referral turnaround time expectations
  • Participate in daily huddles and team touchpoints to review priorities, workflows, and operational updates
  • Provide education, guidance, and ongoing support to providers and center staff regarding referral workflows, PCO guidelines, and best practices
  • Serve as a resource for referral-related questions to promote consistency, efficiency, and improved patient access to care
  • Escalate complex, urgent, or non-standard referrals in accordance with PCO escalation pathways
  • Support departmental initiatives focused on operational efficiency, compliance, and patient-centered care

Benefits

  • Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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