Referral Coordinator (Hybrid Remote)
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Job Location:
Manchester, CT - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Schedule: In-office TuesdayThursday; remote Monday & Friday
Compensation: $25/hour (non-exempt)
Employment Type: Full-time
About the Role
A large managed care organization is seeking a detail-oriented Referral Coordinator to process and track referrals/authorizations coordinate with providers and ensure members receive timely access to care. This role blends member support provider outreach and accurate documentation within established turnaround times.
Key Responsibilities
Create process and track provider referrals and prior authorizations; verify eligibility/benefits.
Review clinical documentation for completeness; route cases per established guidelines.
Communicate with providers facilities and members to obtain missing information and close loops.
Monitor referral status and turnaround times; escalate aging cases and barriers to care.
Document all activities accurately in EMR/authorization platforms; maintain HIPAA compliance.
Answer inbound calls and manage work queues; meet daily productivity and quality metrics.
Collaborate with Utilization Management Care Management and Provider Relations on complex cases.
Generate basic reports (e.g. open referrals denials expirations) and support audits.
Qualifications
12 years in a health plan provider office or hospital setting handling referrals/authorizations.
Working knowledge of medical terminology CPT/HCPCS and ICD-10 payer rules and TAT standards.
Proficiency with EMR/authorization portals and Microsoft Outlook/Excel/Teams.
Strong communication follow-up and customer service skills; high attention to detail.
Ability to protect PHI and follow HIPAA and organizational policies.
Must be able to work on-site in Manchester NH TuesdayThursday and reliably work remote Monday & Friday.
Preferred
Experience in managed care/utilization management.
Familiarity with NH provider networks and regional health systems.
Bilingual skills a plus.
Work Environment & Requirements
Standard business hours with occasional flexibility for operational needs.
Quiet home workspace for remote days; reliable high-speed internet.
Background check and I-9 employment eligibility required.
Benefits
Competitive hourly pay and eligibility for employer benefits package
Required Experience:
IC
Key Skills
- Corporate Risk Management
- Electronics
- Infection Control
- Bakery
- ELV
- Accident Investigation
About Company
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