Referral Coordinator

Company Overview:
Agile Occupational Medicine is a leading occupational medicine group with a network of 24 clinics and one surgery center dedicated to providing comprehensive healthcare services to businesses and their employees across California and Yuma, Arizona. We specialize in ensuring the health and well-being of workers through a range of medical services, including injury care (workers’ compensation), physical examinations (employer services), and commercial (urgent care).

Job Summary:

If you have the ability to represent the highest quality of care in all aspects of patient engagement, and a willingness to demonstrate a very caring and respectful demeanor, we want to hear from you. The ideal candidate will reflect our mission of offering highly personalized, compassionate care and be excited by the opportunity to learn and grow with the Practice. Candidate should also be able to demonstrate a positive attitude, strong communication, and computer skills.

The Referral Coordinator is responsible for managing and processing all Requests for Authorization (RFAs) ordered by the primary treating physicians for outside diagnostic testing, specialty provider referrals, and other ancillary services. The Referral coordinator will review all RFAs for completion as mandated by the State of California Department of Workers’ Compensation. This individual will serve as a liaison between our patients, patient care coordinators and other medical staff. This role demands multi-tasking in a fast-paced environment.

Responsibilities:

• Timely and accurately submits RFA to appropriate Work Comp Insurance Claims Administrator.
• Follow-up on pending authorizations for all referrals.
• Communicates with Clinic Operations Managers and Employers to obtain claims data such as claim numbers and claims adjuster contact information.
• Delegates authorization tracking to RFM Call Center team for follow-up.
• Collaborates with RFM Call Center and Patient Care Coordinators to resolve issues with pending authorizations.
• Coordinate and schedule authorized treatment referrals to internal and external Therapy and Ancillary Providers.
• Performs troubleshooting when problem situations arise; taking independent action to resolve complex issues.
• Provides support to providers with referral submission and modifications.
• Manage heavy phone calls throughout the day.
• Provide status updates to patients and providers as well as claims administrators.
• Notifies patient care coordinators, and physicians of determinations received for external specialty referrals.
• Provide excellent customer service by acting as a liaison for employers, insurers, case managers, and Agile Providers.
• Perform additional duties as assigned.

Competencies:

1. Critical thinker, ethical conduct and possess a leadership mindset.

2. Excellent communication skills and accurate data entry.

3. Strong written and verbal communication skills.

4. Detail oriented with strong organizational and time management skills.

5. Ability to work fluidly: independently or in a team setting, takes initiative, and work with little direction.

6. Must have a strong sense of discretion, urgency, and professionalism.

Preferred Qualifications:

• High School Diploma required
• CA Workers Compensation experience a plus
• At least 3-4 years of work experience in a similar role
• Medical Terminology
• Bilingual – English/Spanish preferred
• Experience working with an EMR/HER system
• Accurate typing skills
• Computer Savvy

Benefits:

• Optimal work life balance with no nights, no weekends, and no holidays requirement to work
• Competitive salary and commission structure
• Comprehensive benefits package
• Opportunity to work in a fast-paced and dynamic environment
• Be part of a team that is passionate about making a difference

Why You Should Join Our Team:
We are a rapidly growing company with a fun and collaborative work environment. We are passionate about disrupting the world of occupational medicine, and we are committed to providing our customers and patients with the best possible experience. We offer our employees competitive salaries, commission, and benefits, and we give them the opportunity to make a real impact on the business.

Salary Range: $21-25 Hourly. Exact compensation may vary based on skills, experience, and location.

Agile Occupational Medicine is an Equal Opportunity Employer. Agile does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided upon qualifications, merit, and business need.