Clinical Referral Specialist LPN

The Patient Coordinator serves as a liaison for referrals, pre-certifications, and authorization requests by coordinating efforts between multiple departments to ensure patient needs are met in a timely and accurate manner.

This position involves managing referrals and obtaining required authorizations from insurance carriers, collecting and documenting information, and ensuring compliance with HIPAA regulations and organizational policies and procedures. The Patient Coordinator must demonstrate strong attention to detail, organizational skills, and the ability to work independently while maintaining excellent customer service.

Key Responsibilities:

• Coordinate and process patient referrals, pre-certifications, and insurance authorizations

• Communicate with insurance carriers to obtain required approvals

• Collect, verify, and document patient and referral information accurately

• Ensure compliance with HIPAA regulations and organizational protocols

• Collaborate with internal departments to facilitate timely patient care

• Maintain accurate records and documentation within the medical record system

Qualifications:

Education:

• Graduation from an accredited Licensed Practical Nursing (or Registered Nurse) program required

Experience:

• 1–2 years of insurance experience with knowledge of insurance coverage processes preferred

Knowledge & Skills:

• Excellent organizational and customer service skills

• Strong computer skills including word processing, data entry, and multi-line phone systems

• Knowledge of medical terminology

• Ability to manage multiple tasks and shifting priorities effectively

• Detail-oriented with strong interpersonal communication and professional phone etiquette

• Knowledge of grammar, spelling, punctuation, and medical terminology usage

• Ability to work independently and follow written protocols

• Knowledge of medical office procedures

• Applies logic and sound judgment in performing job duties

• Reliable attendance and punctuality

Licensure, Registration, or Certification:

• Insurance or Coding Certificate preferred

• Medical terminology coursework or other healthcare certifications preferred

Join our Team! NMC Health offers a family friendly environment with the latest technology and a knowledgeable staff. Here you’ll find all departments work together as a team to live out our core values: respect, excellence, service, transparency, and trust.

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