Referral Coordinator at Pain Treatment Centers of America

Description

REFERRAL COORDINATOR

Job Title:

Referral Coordinator

Supervisor:

Director of New Patient Services

Employment Type:

Full-Time

FLSA Classification:

Non-Exempt

Location:

Batesville, AR

SUMMARY OF RESPONSIBILITIES

The Referral Coordinator is responsible for managing and coordinating patient referrals for VA, UHC, Texas BCBS HMO, and all other insurances as needed. This position ensures timely and accurate processing of referrals, maintains compliance with payer requirements, and provides excellent customer service to patients, providers, and internal staff.

ESSENTIAL FUNCTIONS

1. Coordinates and processes referrals for VA, UHC, Texas BCBS HMO, and all other programs in accordance with established guidelines.
2. Reviews referral requests for completeness and accuracy; obtains necessary authorizations from insurance carriers.
3. Communicates with patients, providers, and insurance representatives to facilitate referral approvals and scheduling.
4. Maintains accurate documentation of all referral activities in the electronic health record (EHR) and referral tracking systems.
5. Monitors referral status and follows up to ensure timely completion and patient care continuity.
6. Adheres to productivity and quality standards established by leadership.
7. Navigates EHR, payer portals, and other software systems as necessary.
8. Maintains open communication with clinical and administrative staff regarding referral requirements and updates.
9. Assists with troubleshooting referral issues and escalates complex cases to the New Patient Referral Lead as needed.
10. Performs other related duties as assigned.

CORE COMPETENCIES

• Excellent oral and written communication skills
• Strong customer service and interpersonal skills
• Knowledge of medical terminology and insurance processes
• High attention to detail and accuracy
• Strong organizational and time management skills
• Proficiency in computer systems and data entry
• Ability to work collaboratively in a fast-paced environment

REQUIRED EDUCATION, EXPERIENCE, AND/OR CERTIFICATIONS

• High school diploma or equivalent required
• One (1) year of experience in medical office, insurance, or referral coordination preferred
• Familiarity with Medicaid and commercial insurance plans is a plus

WORKING ENVIRONMENT AND PHYSICAL DEMANDS

This is a full-time position. Standard hours are 8:00 a.m. to 5:00 p.m. (Monday through Thursday) and 8:00 a.m. to 12:00 p.m. (Friday). Occasional overtime may be required. The position operates in a professional office environment and involves sitting, typing, speaking, listening, and using standard office equipment.

Requirements

High school diploma or equivalent required

One (1) year of experience in medical office, insurance, or referral coordination preferred

Familiarity with Medicaid and commercial insurance plans is a plus