The Medical Referral Coordinator provides excellence in customer service to Neurology Care’s referral sources and their claimants/patients. Daily activities include inbound/outbound call handling, verifying insurance coverage, obtaining authorizations, securing and reviewing required documentation, processing orders, and completing follow-up. The Medical Referral Coordinator is responsible for facilitating patient referrals from primary to specialty care providers.
Key Responsibilities: Technical and Clinical Skills
Serve as key liaison between patients, healthcare providers, and insurance companies to ensure seamless referrals and timely access to specialized care
Coordinate medical referrals, authorizations, and scheduling
Verify insurance benefits and obtain necessary approvals in compliance with reimbursement guidelines and customer rules ***In clinic reimbursement guidelines, “customer rules” typically refer to the provider’s obligations to patients and payers that ensure accurate billing, compliance, and fair payment. These rules are designed to protect both the clinic and the patient while meeting regulatory requirements.
Identify and resolve referral-related issues
Ensure all referral procedures comply with legal and medical standards
Accurately completes and/or updates patient records
Processes orders in a timely and accurate manner per all applicable policies and procedures
Notifies supervisor of issues that hinder process, unsatisfied customers, or any other significant negative customer service circumstance
Maintain patient confidentiality and data security as part of HIPAA compliance
Ensure all referral procedures comply with legal and medical standards
Accurately completes and/or updates patient records
Processes orders in a timely and accurate manner per all applicable policies and procedures
Notifies supervisor of issues that hinder process, unsatisfied customers, or any other significant negative customer service circumstance
Maintain patient confidentiality and data security as part of HIPAA compliance
Interpersonal and Communication Skills
Communicate effectively with all patients; families; licensed personnel; insurance companies and third-party payers
Advocate for patients interests by guiding them through complex neurological care pathways, resolving barriers, and providing timely information
Collaborate with internal teams to ensure efficient workflow
Qualifications
1-2 years of experience in medical referrals or related field
Strong communication and organizational skills
Proficiency in medical terminology and insurance processes
Ability to work in a fast-paced environment
Other duties as assigned
Benefits
Medical, Dental, and Vision insurance
Paid Time Off
401(k) Retirement Plan
Great Work Environment