Referral Navigator Representative

Job Summary

To support patient care coordination, the remote Referral Navigator Representative will manage referral completion, home health services, and durable medical equipment requests while ensuring effective communication among healthcare providers and stakeholders.

Key responsibilities:

• Serve as a centralized resource for care navigation and coordination within the Medical Management Department
• Perform initial review, triage, and validation of clinical and administrative documentation for authorization processes
• Coordinate with various healthcare professionals and departments to facilitate timely progression of patient care requests

Required qualifications:

• High School diploma or GED from an accredited program
• 2+ years of experience in managed care, utilization management, or healthcare operations
• Experience interacting with healthcare providers and managing care coordination activities
• Proficiency in utilizing electronic medical records (EMR) and healthcare information systems
• Knowledge of medical terminology, referral management, and authorization processes