What are the responsibilities and job description for the Referral Coordinator (Hybrid Remote) position at Morgan Stephens?
Schedule: In-office Tuesday–Thursday; remote Monday & Friday
Compensation: $25/hour (non-exempt)
Employment Type: Full-time
About the Role
A large managed care organization is seeking a detail-oriented Referral Coordinator to process and track referrals/authorizations, coordinate with providers, and ensure members receive timely access to care. This role blends member support, provider outreach, and accurate documentation within established turnaround times.
Key Responsibilities
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Create, process, and track provider referrals and prior authorizations; verify eligibility/benefits.
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Review clinical documentation for completeness; route cases per established guidelines.
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Communicate with providers, facilities, and members to obtain missing information and close loops.
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Monitor referral status and turnaround times; escalate aging cases and barriers to care.
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Document all activities accurately in EMR/authorization platforms; maintain HIPAA compliance.
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Answer inbound calls and manage work queues; meet daily productivity and quality metrics.
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Collaborate with Utilization Management, Care Management, and Provider Relations on complex cases.
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Generate basic reports (e.g., open referrals, denials, expirations) and support audits.
Qualifications
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1–2 years in a health plan, provider office, or hospital setting handling referrals/authorizations.
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Working knowledge of medical terminology, CPT/HCPCS and ICD-10, payer rules, and TAT standards.
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Proficiency with EMR/authorization portals and Microsoft Outlook/Excel/Teams.
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Strong communication, follow-up, and customer service skills; high attention to detail.
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Ability to protect PHI and follow HIPAA and organizational policies.
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Must be able to work on-site in Manchester, NH Tuesday–Thursday and reliably work remote Monday & Friday.
Preferred
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Experience in managed care/utilization management.
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Familiarity with NH provider networks and regional health systems.
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Bilingual skills a plus.
Work Environment & Requirements
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Standard business hours, with occasional flexibility for operational needs.
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Quiet home workspace for remote days; reliable high-speed internet.
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Background check and I-9 employment eligibility required.
Benefits
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Competitive hourly pay and eligibility for employer benefits package
Salary : $25
