What does a referral coordinator do?
A referral coordinator works with insurance companies and care providers to share essential patient information and assists primarily in scheduling appointments and managing health insurance issues. As a referral coordinator, you will work directly with the patient, patient families, or even social workers, depending on the job and patient needs. Other job responsibilities include general administrative or clerical tasks such as setting up appointments for new and existing patients, verifying insurance information before appointments, and answering phone calls.
Referral coordinator responsibilities
Here are examples of responsibilities from real referral coordinator resumes:
- Establish rapport with all PCP offices, hospital personnel, and manage care representatives.
- Ensure CPT and ICD-9 coding are accurate and complete according to AMA's guidelines and for third party intermediaries.
- Contact medical insurance companies and provide ICD-9 diagnosis and CPT procedure codes for patient's illness, condition or injury.
- Apply ICD-9 and CPT-4 codes to complete referral requests online or via fax.
- Conduct the entire office's EHR process and create a system to track old and new patient's records.
- Incorporate core organizational values of quality, respect, integrity, partnership, and compassion in all activities and decisions.
- Complete the selection process and implementation of the computer network, practice management and EHR systems including hardware and software applications.
- Adhere to HIPAA and patient confidentiality requirements.
- Coordinate paperwork for reception department and MRI technician.
- Obtain medical records from EMR and submit documentation to specialists/hospitals.
- Verify patient health insurance information with major carriers including Medicaid.
- Determine eligibility and authorization for Medicaid for medical office visits.
- Initiate EMR by entering demographics, referring and certifying physicians and family information.
- Maintain customer confidence and protection of medical information by complying with HIPAA guidelines and regulations.
- Provide Medicare patients with Tricare as secondary by coordinating care with civilian providers when need.
Referral coordinator skills and personality traits
We calculated that 30% of Referral Coordinators are proficient in Patients, Customer Service, and Medical Terminology. They’re also known for soft skills such as Writing skills, Interpersonal skills, and Organizational skills.
We break down the percentage of Referral Coordinators that have these skills listed on their resume here:
- Patients, 30%
Verify patient eligibility information with insurance coverage, and assign patients to providers in the relevant system.
- Customer Service, 12%
Provide exceptional customer service by communicating positively with patients who call and making every effort to meet their needs and expectations.
- Medical Terminology, 7%
Maintain generic knowledge of medical terminology in order to facilitate referrals properly and expeditiously.
- Patient Care, 4%
Coordinated patient care.- Scheduled follow up appointments and testing.- Obtained authorization from insurance companies for procedures and physicians.
- Data Entry, 4%
Identify appropriate referral resource for service based on patient insurance/ program status and data entry.
- EMR, 3%
Monitor EMR systems to assure no breach of patient privacy according to the patient privacy act (HIPPA).
"patients," "customer service," and "medical terminology" are among the most common skills that referral coordinators use at work. You can find even more referral coordinator responsibilities below, including:
Writing skills. One of the key soft skills for a referral coordinator to have is writing skills. You can see how this relates to what referral coordinators do because "secretaries and administrative assistants write memos and emails when communicating with managers, employees, and customers." Additionally, a referral coordinator resume shows how referral coordinators use writing skills: "completed various tasks, including pre-certing stress tests and other procedures, answering phone calls and writing referrals. "
Interpersonal skills. Many referral coordinator duties rely on interpersonal skills. "secretaries and administrative assistants interact with clients, customers, or staff," so a referral coordinator will need this skill often in their role. This resume example is just one of many ways referral coordinator responsibilities rely on interpersonal skills: "possess strong client/goal orientation, and excellent interpersonal, communication and computer skills. "
Organizational skills. This is an important skill for referral coordinators to perform their duties. For an example of how referral coordinator responsibilities depend on this skill, consider that "secretaries and administrative assistants keep files, folders, and schedules in order so that an office runs efficiently." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of a referral coordinator: "reviewed healthcare claims based on organizational & cms guidelines. ".
The three companies that hire the most referral coordinators are:
- Humana63 referral coordinators jobs
- Cano Health35 referral coordinators jobs
- Elevance Health
27 referral coordinators jobs
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Compare different referral coordinators
Referral coordinator vs. Medical scheduler
A medical scheduler typically works with patients to coordinate appointment dates and times with health care professionals. Medical schedulers often work in hospitals, outpatient care centers, and other medical practices. They perform other duties aside from managing patients' schedules that includes providing patients the information they need about the hospital and its policies, providing patient support, and handling and managing questions from patients. Medical schedulers also act as a link between patients, clinical staff, and referral sources.
While similarities exist, there are also some differences between referral coordinators and medical scheduler. For instance, referral coordinator responsibilities require skills such as "appointment scheduling," "front desk," "insurance coverage," and "ehr." Whereas a medical scheduler is skilled in "triage," "scheduling patient appointments," "outbound calls," and "inbound calls." This is part of what separates the two careers.
Medical schedulers really shine in the health care industry with an average salary of $32,016. Comparatively, referral coordinators tend to make the most money in the health care industry with an average salary of $35,297.On average, medical schedulers reach similar levels of education than referral coordinators. Medical schedulers are 3.1% less likely to earn a Master's Degree and 0.1% less likely to graduate with a Doctoral Degree.Referral coordinator vs. Medical receptionist
Medical receptionists are responsible for manning the front desk at a medical facility such as a clinic or a hospital. They manage schedules and appointments in the clinic or hospital. They help patients to their respective appointments. They also assist doctors, nurses, and other medical practitioners by ensuring that the schedule for the day is being followed. They are also in charge of assisting visitors by directing them wherever they would need to go. Medical receptionists also answer inquiries by patients or visitors. Medical knowledge, great customer service skills, and a friendly attitude are needed.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that referral coordinator responsibilities requires skills like "emr," "appointment scheduling," "home health," and "strong customer service." But a medical receptionist might use other skills in their typical duties, such as, "check-in," "office equipment," "patient registration," and "patient flow."
Medical receptionists may earn a lower salary than referral coordinators, but medical receptionists earn the most pay in the health care industry with an average salary of $32,483. On the other hand, referral coordinators receive higher pay in the health care industry, where they earn an average salary of $35,297.medical receptionists earn similar levels of education than referral coordinators in general. They're 3.3% less likely to graduate with a Master's Degree and 0.1% less likely to earn a Doctoral Degree.Referral coordinator vs. Medical office administrator
A medical office administrator is responsible for performing administrative and clerical duties within a health care institution, supplying physicians and medical professionals with patients' information, and coordinating with insurance companies. Medical office administrators handle the information and data management system to ensure the accuracy of patients' details, medical history, and treatment plans. They also schedule doctor appointments and cancellations, as well as monitoring the inventory of medical supplies. A medical office administrator submits payment reports, respond to patients' inquiries and concerns, and process billing disputes.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a referral coordinator is likely to be skilled in "emr," "home health," "strong customer service," and "referral process," while a typical medical office administrator is skilled in "provides administrative support," "office equipment," "medical insurance," and "pet."
Medical office administrators earn the highest salary when working in the health care industry, where they receive an average salary of $34,449. Comparatively, referral coordinators have the highest earning potential in the health care industry, with an average salary of $35,297.medical office administrators typically earn similar educational levels compared to referral coordinators. Specifically, they're 1.1% less likely to graduate with a Master's Degree, and 0.0% less likely to earn a Doctoral Degree.Referral coordinator vs. Front office coordinator
A front office coordinator is responsible for assisting clients with their inquiries and concerns and directing them to the appropriate department and personnel to immediately address their needs. Front office coordinators schedule appointments, verify visitors' identities by checking their credentials for security purposes, processing service payments, updating customers' data and visitation log on the database, and escalating high-level complaints. A front office coordinator also performs administrative and clerical tasks as needed, requiring them to have excellent time-management and organizational skills.
Even though a few skill sets overlap between referral coordinators and front office coordinators, there are some differences that are important to note. For one, a referral coordinator might have more use for skills like "medical terminology," "phone calls," "home health," and "strong customer service." Meanwhile, some responsibilities of front office coordinators require skills like "office equipment," "patient check," "payroll," and "patient flow. "
The health care industry tends to pay the highest salaries for front office coordinators, with average annual pay of $32,333. Comparatively, the highest referral coordinator annual salary comes from the health care industry.The average resume of front office coordinators showed that they earn similar levels of education compared to referral coordinators. So much so that theyacirc;euro;trade;re 2.1% less likely to earn a Master's Degree and less likely to earn a Doctoral Degree by 0.2%.Types of referral coordinator
Updated January 8, 2025
