Medicare Referral Coordinator
$35,360–$50,461 year
On-site · Mount Airy, North Carolina, United States
Job Summary
Medicare Referral Coordinator role: act as the primary point of contact for incoming/outgoing patient referrals, triage referrals, gather information, and ensure timely processing and assignment to providers. Coordinate appointments and transitions of care between primary care, specialists, hospitals, and other settings; schedule patients using the coordinated provider list (CPL); notify patients of date, time, and location. Use web-based insurance platforms to generate referral authorizations, communicate patients' needs to physicians, and ensure referrals are completed with documentation uploaded to the medical record system for PCP follow-up. Address missed external appointments and handle referral-related calls with exemplary customer service. Proficiency in medical terminology and CPT/HCPCS/ICD coding, strong organizational skills, ability to multi-task, and proficiency with Microsoft Office Suite. English fluency required; bilingual preferred. Flexible to work evenings, weekends and/or holidays as needed.
Required Qualifications
- High School diploma or equivalent
- A minimum of 1 year of referral experience in a healthcare setting required
- Experience with web-based insurance sites and obtaining referrals/authorizations for multiple payors preferred
- Experience with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred
- Healthcare experience within the Medicare Advantage population preferred
- Medical Assistant certification preferred
- CPR for Healthcare Providers is preferred
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