Referral Specialist
Hybrid · McAllen, Texas, United States
Job Summary
Referral Specialist responsible for care coordination, appointment scheduling, and member advocacy; will manage internal referral processes, obtain authorizations, register patient information, communicate with providers and insurance, and assist patients with barriers to care. Role emphasizes HIPAA compliance, use of EHR, tracking referrals, and acting as a liaison between members and providers to ensure timely approvals and smooth referrals. Bilingual English/Spanish preferred; remote-work potential after initial on-site period. Strong emphasis on customer service, detailed documentation, and ability to navigate the healthcare system to maximize patient care and provider coordination.
Required Qualifications
- High school diploma or GED
- 3-5 years of experience in customer service or related equivalent experience
- 1-3 years of experience working in a healthcare setting
- Knowledge of ICD-10 and CPT-4 coding, and medical terminology
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