We are seeking an experienced
Referral Coordinator to join a busy orthopedic practice. The ideal candidate will have a strong understanding of medical insurance, referral management, and authorization workflows. This individual will play a key role in ensuring patients receive timely access to specialty care while maintaining compliance with payer requirements.
Hands-on experience with
ModMed (Modernizing Medicine) is required, and prior experience in an orthopedic or other specialty practice is highly preferred.
Key Responsibilities
- Process incoming and outgoing patient referrals accurately and efficiently.
- Verify insurance eligibility, benefits, referral requirements, and payer-specific guidelines.
- Coordinate referrals with primary care providers, specialists, imaging centers, therapy providers, and surgical facilities.
- Obtain and track referrals and authorizations to ensure services are approved prior to patient appointments or procedures.
- Maintain accurate referral documentation within ModMed (Modernizing Medicine).
- Communicate with insurance companies, physician offices, and patients regarding referral status and required documentation.
- Monitor referral work queues and ensure timely follow-up on pending requests.
- Resolve referral-related issues and escalate complex cases when appropriate.
- Collaborate with clinical staff and providers to ensure continuity of patient care.
- Maintain compliance with HIPAA and organizational policies.
Qualifications
- Minimum of 2 years of referral coordination experience in a medical practice.
- Extensive knowledge of commercial insurance, Medicare, Medicaid, HMO, PPO, POS, workers compensation, and referral requirements.
- Strong understanding of prior authorization and referral processes.
- Hands-on experience with ModMed (Modernizing Medicine).
- Excellent organizational skills with the ability to manage multiple priorities.
- Strong verbal and written communication skills.
- High attention to detail and commitment to accuracy.
- Proficient with Microsoft Office and general computer applications.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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