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Referral Management Coordinator
Franciscan Health. Process internal, incoming, and external referrals for all ambulatory services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in processing medical referrals and obtaining prior authorizations while ensuring compliance with referral policies. Strong communication skills are essential for discussing financial responsibilities and coordinating with insurance companies.
Highest-signal resume keywords
Medical Referrals ProcessingPrior Authorization ExperiencePatient SchedulingInsurance CommunicationHealthcare Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Referral PoliciesPrior AuthorizationPatient Demographics ManagementInsurance VerificationMedical History Presentation
Soft Skills
CommunicationOrganizational SkillsPrioritization
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Ambulatory ServicesHealthcareInsurance CompaniesMedical Necessity
About the role
Key responsibilities & impact- Process internal, incoming, and external referrals for all ambulatory services
- Obtain prior authorizations
- Schedule patients
- Work inbound and outbound phone calls
- Discuss copayment, prepayment, and outstanding balance responsibilities with patients
- Follow and regularly utilize current, standardized referral policies and workflows
- Prioritize referrals by urgency and address them promptly
- Ensure complete demographic, insurance, and pertinent clinical information is sent to referred specialists
- Contact insurance companies to meet prior approval requirements
- Present medical history, diagnosis, prognosis, and other necessary information to insurance companies to establish medical necessity
- Review referral details and expectations with ordering providers and patients
Requirements
What you’ll need- High School Diploma/GED required
- 2 years of medical referrals, healthcare, and/or prior authorization experience required
- Prior authorization experience
- Ability to process internal, incoming, and external referrals for ambulatory services
- Travel required: Never or rarely
Benefits
Comp & perks- Comprehensive benefit offerings for eligible employees