Description
We are seeking a highly detail-oriented, proactive, and experienced Bilingual Referral Coordinator to support our growing orthopedic practice. In this role, you will be the critical link ensuring patients transition smoothly from their initial referral through to physical therapy, advanced imaging, or orthopedic surgical procedures.
The adecuado candidate possesses a deep administrative understanding of the insurance referral and prior authorization process, is fully bilingual in English and Spanish, and has hands-on experience in a U.S.-based medical office. Prior experience navigating the ModMed EMR platform will give you a significant advantage in this role.
Primary Responsibilities:
Referral Processing & Tracking
- Care Coordination: Process and track both incoming and outgoing referrals for orthopedic consultations, advanced imaging (MRIs, CT scans), physical therapy, and surgical procedures.
- Seamless Transitions: Coordinate directly with ordering providers, specialists,
and ancillary clinical facilities to ensure medical records and referral packages are successfully received.
- Proactive Follow-ups: Systematically follow up on pending referrals and outstanding authorizations to prevent any clinical delays in patient care.
Insurance Verification & Prior Authorization
- Coverage & Eligibility: Verify patient insurance benefits and successfully obtain prior authorizations for referred orthopedic services.
- Financial Integrity: Collaborate closely with our billing team to ensure all secured authorization numbers are captured and correctly documented prior to the patient's scheduled service.
- Data Accuracy: Utilize working knowledge of CPT and ICD-10 codes to submit accurate clinical authorization requests to insurance portals.
Bilingual Patient & Provider Communication
- Call Management: Confidently handle a high volume of inbound and outbound phone calls from patients, medical providers, and insurance carriers.
- Linguistic Support: Communicate c