Referrals Out Coordinator

About the role

The Referrals Out Coordinator is responsible for managing the coordination of patient referrals to external specialists, facilities, and healthcare providers. This role serves as a liaison between patients, providers, insurance companies, and outside healthcare networks to ensure timely, accurate, and efficient referral processing.

Key responsibilities

• Review and process outgoing referral orders submitted by healthcare providers.
• Gather and verify all required clinical documentation, including provider orders, chart notes, and supporting medical records.
• Ensure referral requests are complete and accurate before submission.
• Verify patient insurance eligibility and benefits.
• Confirm specialist and facility network participation and identify in-network provider options.
• Ensure referrals comply with payer guidelines and requirements.
• Compile and submit required clinical documentation to the Prior Authorization team.
• Monitor authorization status and follow up as needed to support timely approvals.
• Send referral packets and medical documentation to external providers and facilities.
• Coordinate and schedule specialist appointments on behalf of patients.

About you

• Bachelor's degree in any healthcare-related course preferred (e.g., Healthcare Administration, Medical Technology, Nursing, Biology, Public Health, or other related fields).

• Minimum of 1 to 2 years of experience in a medical office, clinic, hospital, or healthcare setting.

• Previous experience in referral coordination, insurance verification, medical scheduling, or prior authorization is preferred.

• Strong understanding of medical terminology, insurance verification processes, and HIPAA regulations.

• Experience working with Electronic Medical Records (EMR/EHR) systems.

• Proficiency in Microsoft Office Suite and other healthcare-related software.

• Excellent organizational skills with strong attention to detail.

• Effective verbal and written communication skills.