Job Overview
The Neurology Institute is a busy, multi-specialty private practice in Coral Springs seeking an experienced, high-energy Medical Referral Coordinator. Because our practice manages a high volume of HMO patients, this role is critical to our daily operations. You will ensure all incoming HMO insurance referrals are secured, verified, and correctly documented before patients are seen. If you are highly organized and know how to navigate the complexities of HMO networks, we want you on our team.
Key Responsibilities
- HMO Management: Secure, track, and process incoming patient referrals from primary care physicians and HMO networks.
- Insurance Verification: Verify patient eligibility and benefits to confirm referral requirements are met prior to appointments.
- Clinic Coordination: Work closely with the scheduling team to clear patients for their visits and resolve missing referral issues.
- Payer Communication: Navigate online insurance portals and contact insurance companies directly to expedite pending referrals.
- Documentation: Accurate data entry of authorization numbers, expiration dates, and allowed visit counts into the EHR.
- Utilize eClinical Works for accurate documentation and record management.
- Apply medical coding principles, including CPT and ICD-10 to ensure proper billing and documentation.
- Maintain knowledge of health insurance policies, managed care protocols, and insurance verification procedures.
- Collaborate with medical staff to ensure compliance with HIPAA regulations and clinical confidentiality policies.
- Communicate effectively with patients regarding referral procedures, insurance requirements, and appointment scheduling.
- Use Microsoft Office tools to generate reports, track referral statuses, and manage administrative tasks efficiently.
- Stay updated on changes in health insurance policies and medical coding standards to ensure ongoing compliance.
Qualifications
- Minimum of two (2) years of experience managing medical referrals, specifically handling high-volume HMO plans.
- Prior experience working in a multi-specialty private practice setting is required.
- Strong understanding of South Florida HMO networks, insurance portals (Availity, etc.), and authorization workflows.
- Proficiency in medical terminology and familiarity with medical records management.
- Proficiency with EMR/EHR systems for documentation and data entry is essential.
- Knowledge of CPT coding, ICD-9, ICD-10 coding standards, and ICD coding practices for accurate billing.
- Excellent customer service skills with the ability to communicate clearly and professionally with patients and healthcare providers.
- Understanding of HIPAA regulations to maintain patient privacy and confidentiality at all times.
- Competency in Microsoft Office applications for administrative reporting and record keeping.
- Ability to multitask effectively in a fast-paced environment while maintaining attention to detail.
Join our team as a Medical Referral Coordinator to ensure smooth referral processes that enhance patient care delivery while adhering to industry standards and regulations!
Pay: From $20.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
