Top 377 Referral coordinator Jobs in Bethesda, Md

Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $23.56 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $24.13 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Outreach Case Manager - Entry Level
Centers for Behavioral Health —Derwood, MD
- $17.73 an hour
- Full-time
- Hybrid work
- CPR Certification
- Computer literacy
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Licensed Practical Nurse Referral Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $34.57 an hour
- Nursing
- Microsoft Excel
- Microsoft Outlook
Care Manager
Amerihealth Caritas —Washington, DC
- $83,400 - $113,600 a year
- Full-time
- Microsoft Word
- Nursing
- Microsoft Outlook
- Commuter assistance
- Paid holidays
Operations Coordinator - NIH
Global Solutions Network Inc —Bethesda, MD
- $38.67 - $44.96 an hour
- Full-time
- Customer service
- Mid-level
- Office
- Travel reimbursement
- Profit sharing
Quick Apply
Remote Central Intake Coordinator
Emmett Healthcare —Washington, DC
- $80,168.39 - $90,000.00 a year
- Full-time
- Remote
- HIPAA
- Mid-level
- Case management
Quick Apply
6d
Operations Coordinator - NIH (Short-Term)
Global Solutions Network Inc —Bethesda, MD
- $41.00 - $43.50 an hour
- Temporary
- Research
- Mid-level
- Bachelor's degree
- Travel reimbursement
- Profit sharing
Quick Apply
Patient Coordinator
Axle —Bethesda, MD
- $100,000 - $108,000 a year
- Writing skills
- Bachelor's degree
- Mentoring
- Paid holidays
- Health insurance
Quick Apply
Resident Services Coordinator
The Grandview by Erickson Senior Living —Bethesda, MD
- $54,940 - $70,000 a year
- Mid-level
- Geriatrics
- Health insurance
- Dental insurance
8d
Clinic Coordinator (Morning)
Rehab 2 Perform —Bethesda, MD
- $21 - $23 an hour
- Monday to Friday
- Anatomy knowledge
- Inventory management
- Physical & Rehabilitation Medicine
- Paid holidays
- Health insurance
Quick Apply
3d
Medical Office Clerk
LTSi - Laredo Technical Services, Inc. —Bethesda, MD
- $22.00 - $22.50 an hour
- Urgently hiring
- Primary Care
- English
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
5d
Patient Service Coordinator MHUC
MedStar Health —Rockville, MD
- $18.70 - $32.72 an hour
- Full-time
- Urgent Care
- High school diploma or GED
- Computer skills
Workplace Coordinator
Striden —Washington, DC
- $31 an hour
- Full-time
- Office
- High school diploma or GED
- Ability to lift 50 pounds
- Health savings account
- Health insurance
Quick Apply
2d
Patient Service Coordinator MAS
MedStar Health —Chevy Chase, MD
- $18.70 - $32.72 an hour
- Full-time
- High school diploma or GED
- Computer skills
- 1 year
Patient Access Representative
Children's National Hospital —Washington, DC
- $20.75 - $40.99 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- Mid-level
- Commuter assistance
- AD&D insurance
Operations Coordinator
Axle —Rockville, MD
- $60,000 a year
- Inventory management
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
7h
Perinatal Care Coordinator
Children's National Hospital —Washington, DC
- $51,584.00 - $85,987.20 a year
- Full-time
- Nursing
- Mid-level
- Education
- Commuter assistance
- AD&D insurance
10d
Patient Access Representative (Full-time)
Children's National Hospital —Montgomery County, MD
- $20.75 - $40.99 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- HIPAA
2d
Patient Service Coordinator
MedStar Health —Washington, DC
- $18.70 - $32.72 an hour
- Full-time
- BLS Certification
- Urgent Care
- High school diploma or GED
2d

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Referral Management (Non-Nurse) Reviewer

Zimmerman Associates, Inc. -
Bethesda, MD

Apply Now

Job Details

$23.56 an hour

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
Customer service
Associate's degree
Medical terminology

Full Job Description

Zimmerman Associates, Inc. (ZAI) is seeking to hire multiple Referral Management (Non-Nurse) Reviewers to support our contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Region’s premier authority for appointment coordination and referral management services for beneficiaries within the Defense Health Network.

Pay Rate: $23.56 per hour plus $4.93 Health & Wellness Fringe

Role and Responsibilities:

Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty referrals for Active-Duty Service Members and TRICARE Prime beneficiaries enrolled at Military Treatment Facilities (MTFs) within the National Capital Region.

This is an onsite opportunity

Qualifications / Skills / Experience:

Minimum of an Associate’s degree
At least 2 years of experience in Utilization Management, Referral Management, Authorization/Denials, or Medical Claims Processing/Insurance Referral
U.S. Citizenship required, with the ability to obtain a Public Trust Clearance
Knowledge of medical care criteria such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs), or other evidence-based Military Health System (MHS) guidelines
Familiarity with medical terminology and ability to learn MHS, VA-DOD Sharing Program, TRICARE, HIPAA, and release of medical information protocols
Excellent communication and interpersonal skills
Strong customer service orientation
Understanding of Access to Care Standards within the Direct Care System
Attention to detail, including correct use of deferral codes
Strong organizational skills with ability to prioritize tasks and manage time effectively
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook) and internet navigation

Essential Tasks:

Review and process referrals for administrative and clinical completeness and appropriateness, completing disposition within 24 hours of referral date
Collaborate with appointing centers, case managers, product line nurses, providers, clinics, managed care contractors, and other healthcare team members to ensure appropriate use of Direct Care and civilian network resources
Ensure patients are scheduled with the right provider, at the right time and place
Review compliance with Specialty Referral Guidelines (SRGs) per IRMAC protocols
Complete and return Clear Legible Reports (CLR) to ordering civilian providers within required Return of Favorable Response (ROFR) timelines
Manage telephone, written, and electronic communications regarding specialty appointments and referrals
Monitor and process referral management worklists (e.g., Genesis Work Lists) to ensure timely consult processing
Communicate referral status to patients, including benefit counseling and advocacy resources as needed
Reschedule or redirect patients within 3 days when referrals are disapproved or invalid, advising on other care options and Line-of-Duty issues
Receive and enter ROFR referrals in MHS-GENESIS from Military Contractor Support Centers (MCSC) portals for assigned specialties/product lines, adhering to all timelines and business rules
Verify patient eligibility and update demographics in MHS-GENESIS
Document patient interactions, especially when appointments are refused, and coordinate with Beneficiary Counselor and Assistance Coordinator as appropriate
Coordinate with product line nurses and clinics for special accommodations
Interface with MCSC and multidisciplinary teams to ensure referral appropriateness
Submit referrals to non-network providers for TRICARE Service Center medical necessity reviews
Monitor referral management voicemail and return patient calls within established guidelines
Provide External Provider Referral Online (EPRO) information as requested
Close unused referrals following DHA IPM and NCR Medical Directorate policies, notifying ordering providers accordingly
Orient and train new IRMAC staff on referral processes and timelines
Perform other duties as assigned

Zimmerman Associates, Inc. is an equal opportunity employer. We comply with Federal and State Equal Opportunity laws and consider qualified applicants without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status, or any other protected status.

#INDSPN

Apply Now

Refine Your Search

referral coordinator jobs in bethesda, md

Referral Management (Non-Nurse) Reviewer

Referral Management (Non-Nurse) Reviewer

Outreach Case Manager - Entry Level

Licensed Practical Nurse Referral Reviewer

Care Manager

Operations Coordinator - NIH

Remote Central Intake Coordinator

Operations Coordinator - NIH (Short-Term)

Patient Coordinator

Resident Services Coordinator

Clinic Coordinator (Morning)

Medical Office Clerk

Patient Service Coordinator MHUC

Workplace Coordinator

Patient Service Coordinator MAS

Patient Access Representative

Operations Coordinator

Perinatal Care Coordinator

Patient Access Representative (Full-time)

Patient Service Coordinator

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