Referral Coordinator – Orthopedic Practice | Permanent WFH

We are seeking an experienced Referral Coordinator to join a busy orthopedic practice. The ideal candidate will have a strong understanding of medical insurance, referral management, and authorization workflows. This individual will play a key role in ensuring patients receive timely access to specialty care while maintaining compliance with payer requirements.

Hands-on experience with ModMed (Modernizing Medicine) is required, and prior experience in an orthopedic or other specialty practice is highly preferred.

Key Responsibilities

• Process incoming and outgoing patient referrals accurately and efficiently.
• Verify insurance eligibility, benefits, referral requirements, and payer-specific guidelines.
• Coordinate referrals with primary care providers, specialists, imaging centers, therapy providers, and surgical facilities.
• Obtain and track referrals and authorizations to ensure services are approved prior to patient appointments or procedures.
• Maintain accurate referral documentation within ModMed (Modernizing Medicine).
• Communicate with insurance companies, physician offices, and patients regarding referral status and required documentation.
• Monitor referral work queues and ensure timely follow-up on pending requests.
• Resolve referral-related issues and escalate complex cases when appropriate.
• Collaborate with clinical staff and providers to ensure continuity of patient care.
• Maintain compliance with HIPAA and organizational policies.
  
  

Qualifications

• Minimum of 2 years of referral coordination experience in a medical practice.
• Extensive knowledge of commercial insurance, Medicare, Medicaid, HMO, PPO, POS, workers' compensation, and referral requirements.
• Strong understanding of prior authorization and referral processes.
• Hands-on experience with ModMed (Modernizing Medicine).
• Excellent organizational skills with the ability to manage multiple priorities.
• Strong verbal and written communication skills.
• High attention to detail and commitment to accuracy.
• Proficient with Microsoft Office and general computer applications.
  
  

Perks

• Permanent Work From Home
• Leave Credits
• Monetary Allowance
• Annual Bonus
• Weekly Paychecks
• Fixed Weekends Off
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary
  
  

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