Healthcare Referral Coordinator with Insurance Expertise

2 weeks ago


Edmond, Oklahoma, United States Medix Full time
Job Title:

Healthcare Referral Coordinator with Insurance Expertise

About the Role:

We are seeking a detail-oriented and motivated Healthcare Referral Coordinator to join our team. As a key member of our organization, you will play a critical role in ensuring patient access and continuity of care during the annual reverification season.

Responsibilities:
  • Process incoming referrals from referral sources and ensure all required documentation is received in a timely manner.
  • Complete intake referral checklists, enter patient demographics, insurance, and authorization details into our computer system.
  • Secure authorizations and re-authorizations as required by payers and document them in the system.
  • Ensure insurance verification is complete and authorization is obtained before the referral is forwarded to a pharmacist.
  • Stay knowledgeable about insurance plans contracted with Amerita, including Medicare, Medicaid, and commercial insurance.
  • Communicate status updates and authorization requirements to the Sales team, pharmacy staff, and other departments.
  • Inform patients and caregivers about insurance coverage and payment responsibilities.
  • Accurately document progress notes and maintain confidentiality of patient information.
  • Manage high-volume administrative tasks typical of AR season, including benefit verification, patient outreach, and prior authorization renewals.
Requirements:
  • Education: High School Diploma/GED required; Associate's Degree or some college preferred.
  • Experience: Minimum 2 years in healthcare referral processing, with knowledge of insurance verification and pre-certification.
  • Insurance Knowledge: Familiar with Medicare, Medicaid, and various commercial insurance types.
  • Communication Skills: Strong verbal and written communication abilities are essential.
  • Healthcare Background: Experience in pharmacy environments (particularly Specialty or Infusion), Patient Access, Intake Coordination, Scheduling, or similar roles in specialty clinics (e.g., Oncology, Cardiology, Gastroenterology) is a plus.
Estimated Salary Range:

$48,000 - $60,000 per year, depending on experience and location.



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