Referral Coordinator II

About the Role
The Referral Coordinator II processes routine and moderately complex referrals, while supporting team productivity and referral workflow coordination.

Primary Responsibilities

• Acts as a developing subject matter resource for referral processes and supports team members with routine questions.

• Serves as liaison between hospital departments, health plans, physicians, patients, vendors and other referral sources to facilitate referral processing.

• Reviews referrals for completeness and accuracy and follows up for additional information when needed. Verifies insurance coverage and obtains authorizations when required according to established processes.

• Contacts physician offices as needed to obtain demographic information or related data.

• Enters referrals, documents communications, actions and other data in system.

• Escalates complex referral issues or authorization challenges to senior staff or leadership as appropriate.

Minimum Qualifications

• High school diploma or GED and 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.

• Strong knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.