Referral Intake Coordinator
On-siteMiami, Florida, United States
Job Summary
Answer and manage high-volume inbound referral calls from provider offices, patients, caregivers, and internal departments. Provide professional guidance regarding referral status, required documentation, authorization requirements, and next steps. Process urgent and STAT referrals to support timely patient access to care. Validate referral completeness, including provider information, diagnosis codes, authorizations, and supporting clinical documentation. Accurately enter and maintain referral information within the electronic medical record system. Communicate with provider offices to obtain missing documentation and resolve referral discrepancies. Escalate urgent or high-priority referrals in accordance with established protocols. Document all calls, actions taken, and follow-up activities accurately and timely. Meet productivity, quality, accuracy, and turnaround-time standards while maintaining compliance with HIPAA, payer guidelines, and company policies. Utilize referral management tools, payer portals, and electronic medical records to support daily operations.
Required Qualifications
- High school diploma or equivalent
- Minimum of two (2) years of referral processing experience in a primary care, managed care, or value-based care setting
- Knowledge of medical terminology, CPT, HCPCS, and ICD coding
- Experience working with Electronic Medical Records (EMR)
- Understanding of referral workflows, authorization requirements, insurance plans, and payer portals
- Proficiency with Microsoft Office applications, including Excel and Outlook
- Strong verbal and written communication skills
- Excellent attention to detail, organizational skills, and ability to manage multiple priorities
- Strong problem-solving and critical-thinking abilities
- Ability to work independently and collaboratively in a fast-paced environment
Desired Qualifications
- Experience with eClinicalWorks (eCW)
- Bilingual in English and Spanish or English and Creole
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