New Patient Coordinator

POSITION SUMMARY

The New Patient Coordinator is responsible for coordinating and facilitating the intake and scheduling of all new patient referrals. This role ensures timely processing of referrals, accurate data entry, and procurement of required authorizations. The position serves as a primary point of contact for patients, attorneys, claims adjusters, nurse case managers, and referring physician offices, delivering a high level of customer service while ensuring compliance with PRCMG standards and payer requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Serve as the primary point of contact for all new patient inquiries and referrals, ensuring a professional and responsive experience
• Receive and process new patient referral requests from applicant attorneys, physician offices, patients, and nurse case managers
• Perform timely outreach and follow-up on all new patient referrals, including initiating contact within established timeframes and utilizing multiple communication methods
• Accurately enter patient demographics, insurance information, and referral details into the electronic medical record (EMR) system
• Maintain accurate tracking logs of referral status, authorization approvals, and scheduling timelines
• Verify insurance eligibility and secure appropriate authorizations prior to scheduling services
• Coordinate with workers’ compensation adjusters, attorneys, and insurance carriers to obtain and expedite authorizations
• Proactively follow up on pending authorizations, referrals, and required documentation to prevent delays in patient care
• Actively manage referral pipelines to support provider schedules and minimize delays in patient access to care
• Retrieve, organize, and upload medical records necessary for provider review prior to scheduled appointments
• Communicate effectively with internal departments and external stakeholders to resolve issues related to referrals, authorizations, and scheduling
• Monitor voicemail throughout the day and return all calls within the same business day
• Ensure compliance with PRCMG policies, HIPAA regulations, and payer guidelines in all interactions and documentation
• Meet or exceed established departmental productivity and performance benchmarks, including scheduling volume, referral conversion timelines, and authorization turnaround standards, as defined by PRCMG and subject to periodic adjustment based on operational needs
• Perform other job-related duties as assigned to support departmental workflow

Qualifications Required (Education, Experience, AND Skills)

• High School Diploma or GED
• Minimum of 2 years of experience in a medical office setting
• Workers’ Compensation experience
• Strong understanding of medical terminology, insurance verification, and authorization processes
• Demonstrated ability to manage high-volume workflows and prioritize tasks effectively
• Excellent verbal and written communication skills with a customer-service focus
• High level of accuracy and attention to detail in data entry and documentation
• Proficient in EMR systems and Microsoft Office applications
• Minimum typing speed of 40 words per minute (WPM)

PREFERRED

• Experience in pain management or multi-specialty medical practice with workers’ compensation exposure
• Proven ability to manage high-volume referrals, scheduling, and authorization workflows
• Proficiency in EMR systems; bilingual (Spanish/English) preferred