Referral Coordinator

Overview

Led by a highly skilled team of anesthesiology and pain management doctors, The Nexus Pain Center are the preeminent pain clinic providing their patients with innovative medical solutions and cutting-edge technologies. These specialists pride themselves on their ability to give their patients the best care and service. The Referral Specialist is responsible for coordinating, processing, and tracking all patient referrals to outside providers and facilities. This role ensures that referrals are accurate, authorized, properly documented, and communicated in a timely manner to support continuity of care and compliance with payer and regulatory requirements.

Hours- 07:30 am-04:00 pm M-T. Fridays 07:30am-01:30pm.

Duties

• Managing incoming and outgoing patient referrals across multiple payers and programs
• Verifying referral information for completeness, accuracy, and appropriateness
• Coordinating referrals for commercial insurance, Tricare, VA, and other managed care plans
• Monitoring authorization requirements and ensuring referrals meet payer guidelines
• Communicating with external providers, facilities, and insurance portals regarding referral status
• Uploading, tracking, and maintaining referral-related documentation in electronic systems
• Ensuring provider orders, clinical notes, and supporting records are properly attached and maintained
• Following up with provider offices to confirm receipt and scheduling of referrals
• Updating referral statuses and documenting all activity in the patient record
• Communicating updates to internal staff and, when required, to external agencies such as the VA
• Identifying delays, errors, or missing information and resolving them proactively
• Maintaining compliance with HIPAA, payer requirements, and internal policies

Preferred Qualifications

• Experience in medical referrals, scheduling, or care coordination
• Familiarity with VA, Tricare, or managed care referral processes
• Knowledge of medical terminology and diagnosis codes
• Experience working in an EMR or referral management system- EClinicalWorks (ECW)

Nexus is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: Nexus is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Nexus are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Nexus will not tolerate discrimination or harassment based on any of these characteristics.