Patient Care Coordinator

RMC Patient Care Call Coordinator

Education: High School Diploma or equivalent

Required Qualifications:

• 1+ years of referral management experience
• 1+ years of medical insurance experience
• 3+ years of customer service
• Knowledge of basic medical terminology
• Strong attention to detail, organizational skills, and time management abilities
• Proficiency in Microsoft Office applications, including Excel, Word, and Outlook
• Ability to navigate multiple software systems and technologies simultaneously in a fast-paced environment

Preferred Qualifications:

• Bilingual in Spanish preferred
• Direct referral management experience within a healthcare setting
• Experience working with health insurance plans, benefit verification, and authorization processes
• Experience with electronic medical records (EMR/HER) systems

Job Responsibilities:

• Managing internal and external referrals, including daily referral reconciliation activities.
• Gathering, reviewing, and processing required referral documentation while ensuring compliance with established turnaround times.
• Answering incoming telephone calls and assisting callers with scheduling, referral inquiries, and other support needs through the phone queue system.
• Delivering exceptional customer service by managing the referral process professionally, accurately, and efficiently.
• Obtaining, updating, and tracking prior authorizations and referral authorizations for internal and external providers.
• Collaborating with providers, patients, and internal departments to resolve referral-related issues.
• Monitoring referral status and ensuring timely follow-up on outstanding requests.
• Maintaining accurate documentation and records within applicable systems.
• Working independently while effectively managing workload and priorities.
• Maintaining a positive and professional demeanor when interacting with internal and external customers.

Position Background: The RMC Patient Care Call Coordinator plays a critical role in supporting referral management operations by ensuring referrals are processed accurately, efficiently, and within established timelines. This position helps facilitate patient access to care by coordinating referrals, obtaining authorizations, and providing exceptional customer service to patients, providers, and internal stakeholders.