Referral Coordinator Team Lead

Job Summary

The Referral Coordinator Team Leader oversees the daily operations of the referral coordination team to ensure timely and accurate processing of all patient referrals. This role provides leadership, guidance, and support to referral coordinators while maintaining strong communication with providers, clinics, and patients to ensure a smooth and efficient referral process. The Team Leader is responsible for monitoring productivity, ensuring compliance with company policies and payer requirements, and assisting with training and performance development.

Job Responsibilities

•    Supervise and support the daily activities of the referral coordination team.
•    Serve as the main point of contact for complex or escalated referral issues.
•    Review and assign referrals to coordinators based on workload and priority.
•    Ensure referrals are processed accurately and within required timeframes.
•    Monitor referral queues and follow up on pending or incomplete requests.
•    Maintain up-to-date knowledge of insurance authorizations, referral requirements, and network providers.
•    Track and report team productivity, accuracy, and turnaround times.
•    Conduct regular team meetings to review updates, provide feedback, and reinforce process standards.
•    Assist with onboarding and training of new referral coordinators.
•    Participate in audits and quality improvement initiatives.
•    Ensure patient confidentiality and compliance with HIPAA regulations.
•    Supports and assists the referral coordination team with processing referral authorizations as needed to ensure accuracy and timely completion.
 

Education and Experience

•    High school diploma or equivalent required.
•    Minimum of one (2) year of relevant work experience.
•    Experience with Web IVRs and managing authorizations for multiple payers preferred.
•    Background in healthcare or clinical settings, especially within Medicare HMO populations, is a plus.
•    Customer service experience required.
•    Leadership or supervisory experience within a healthcare setting strongly preferred.

Knowledge, Skills & Proficiencies

•    Proficient in medical terminology, referral workflows, and insurance authorization procedures.
•    Familiarity with healthcare systems, insurance verification, and referral management tools.
•    Knowledge of HIPAA regulations and patient confidentiality practices.
•    Experience working with EHR systems.
•    Strong communication, time management, and multitasking skills.
•    Strong understanding of insurance authorization, medical terminology, and referral requirements.
•    Excellent communication, interpersonal, and problem-solving skills.
•    Proficiency in EHR systems, fax platforms, and Microsoft Office (Excel, Outlook, Word).
•    Demonstrated ability to prioritize tasks and meet deadlines in a fast-paced environment.
•    Bilingual (English/Spanish) preferred.

Physical Requirements/Working Environment

•    Prolonged periods of sitting and computer use.
•    Frequent use of office equipment including fax, scanners, and telephones.
•    Fast-paced environment requiring task prioritization and timely follow-up.
•    Primary patient interaction is via phone for appointment coordination and follow-up.

AHCA Requirements

This position may require successful completion and maintenance of an AHCA Level 2 background screening in accordance with Florida healthcare regulations. Candidates must be able to meet all eligibility and compliance requirements prior to employment.For additional information regarding AHCA background screening requirements, please visit:https://ahca.myflorida.com/