Position Summary
Advanced MSO is seeking a detail-oriented and compassionate Referral Coordinator to join our growing healthcare operations team. The Referral Coordinator plays a vital role in ensuring patients receive timely specialty care by coordinating referrals, obtaining insurance authorizations, and maintaining accurate communication between providers, specialists, health plans, and patients.
The ideal candidate is highly organized, thrives in a fast-paced healthcare environment, and has a strong understanding of insurance verification, prior authorizations, and medical terminology. This individual will serve as an essential liaison, helping ensure every referral is processed efficiently while delivering an exceptional patient experience.
Key ResponsibilitiesReferral Management
- Process and coordinate incoming and outgoing referrals in a timely and accurate manner.
- Monitor referrals throughout the entire lifecycle, ensuring completion and appropriate follow-up.
- Schedule appointments with specialty providers and confirm patient appointments.
- Track referral status and ensure all required documentation has been received by the specialist.
- Follow up on incomplete or pending referrals to prevent delays in patient care.
Insurance Verification & Authorizations
- Verify patient insurance eligibility and benefits.
- Obtain prior authorizations, referrals, and precertifications as required by health plans.
- Communicate with insurance companies regarding authorization status and coverage requirements.
- Resolve authorization issues and coordinate with providers when additional clinical documentation is needed.
- Maintain knowledge of payer policies, referral guidelines, and authorization requirements.
Patient Communication
- Serve as the primary point of contact for patients regarding referral status and scheduling.
- Educate patients on referral processes, insurance requirements, appointment preparation, and next steps.
- Answer patient questions professionally while providing exceptional customer service.
- Coordinate communication between patients, primary care providers, specialists, and insurance carriers.
Documentation & Medical Records
- Maintain accurate patient records within the Electronic Medical Record (EMR/EHR) system.
- Ensure all referrals, authorizations, medical records, and supporting documentation are complete and properly filed.
- Securely transmit medical records to specialists and healthcare partners as needed.
- Maintain strict compliance with HIPAA and company confidentiality policies.
Quality & Compliance
- Ensure referrals comply with payer requirements, CMS guidelines, and company policies.
- Monitor referral turnaround times and assist in improving workflow efficiency.
- Identify opportunities to streamline referral processes and improve patient satisfaction.
- Participate in departmental quality improvement initiatives and ongoing training.
Team Collaboration
- Collaborate closely with physicians, medical assistants, claims personnel, provider relations, and administrative staff.
- Support additional administrative duties as assigned.
- Build and maintain positive working relationships with provider offices, specialists, and health plan representatives.
QualificationsEducation
- High School Diploma or GED required.
- Associate degree in Healthcare Administration, Medical Assisting, Business Administration, or a related field preferred.
Experience
- 1–3 years of experience in healthcare, medical office administration, referrals, insurance verification, patient services, or a related healthcare setting preferred.
- Experience working with Medicare Advantage, Managed Care Organizations (MCOs), IPA/MSO environments, or specialty referrals is highly desirable.
Technical Knowledge
- Working knowledge of medical terminology.
- Experience using Electronic Medical Record (EMR/EHR) systems.
- Familiarity with insurance verification, referrals, prior authorizations, and healthcare payer guidelines.
- Proficiency in Microsoft Office, including Excel, Outlook, and Word.
- Ability to learn and navigate multiple healthcare software platforms.
Skills & Competencies
- Excellent communication and interpersonal skills.
- Strong customer service mindset with a patient-first approach.
- Outstanding organizational and time management abilities.
- Exceptional attention to detail and accuracy.
- Ability to multitask and prioritize responsibilities in a fast-paced environment.
- Strong problem-solving and critical-thinking skills.
- Ability to work both independently and collaboratively within a team.
- Professionalism, integrity, and compassion when interacting with patients and providers.
Compensation & Benefits
Salary: $17.00 – $23.00 per hour, based on experience and qualifications.
Advanced MSO offers a competitive compensation package, opportunities for professional growth, and the chance to build a rewarding career within a collaborative healthcare organization.
Benefits may include:
- Competitive hourly pay
- Paid Time Off (PTO)
- Paid Holidays
- Opportunities for professional development and career advancement
- Supportive and collaborative team environment
Why Join Advanced MSO?
At Advanced MSO, we believe every patient deserves timely access to quality healthcare. Our Referral Coordinators play a critical role in making that happen by ensuring seamless communication between patients, providers, specialists, and health plans.
We are committed to fostering a workplace built on collaboration, innovation, and excellence. If you enjoy helping patients navigate the healthcare system, thrive in an organized environment, and want to grow your career with a team dedicated to making a difference, we'd love to hear from you.
Pay: $17.00 - $23.00 per hour
Work Location: Hybrid remote in El Centro, CA 92243
