Referral Quality Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $20 - $22 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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IVX Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

🏥 Healthcare

💊 Pharmaceuticals

👥 B2C

Healthcare • Pharmaceuticals • B2C

IVX Health is a national network of outpatient infusion centers that provides biologic infusion and injection therapies for patients with complex chronic conditions such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis, psoriasis, lupus, and severe asthma. The company emphasizes patient comfort and convenience with private suites, flexible scheduling including evenings and weekends, in-network insurance options, and high-quality care delivered by ARNPs, RNs, and medical directors across multiple U. S. locations.

📋 Description

• Review incoming referrals processed through AI-assisted technologies • Verify patient demographics, insurance coverage, provider information, diagnosis details, and supporting clinical documentation • Compare extracted information against source documents to ensure accuracy • Classify referral documentation according to established workflow standards • Identify incomplete, conflicting, duplicate, or inaccurate information • Confirm referrals contain the information required for authorization and scheduling activities • Recognize missing clinical documentation and payer-specific requirements • Resolve routine discrepancies and escalate complex issues when appropriate • Partner with providers, clinical teams, and internal departments to obtain missing information • Prepare referrals for smooth progression into the authorization process • Apply independent judgment when reviewing AI-generated information • Maintain high levels of accuracy while meeting productivity standards • Follow standardized review processes and quality expectations • Identify recurring workflow, documentation, or technology challenges • Contribute to process improvements and adoption of new technologies

🎯 Requirements

• High school diploma or equivalent • 2-3 years of experience in healthcare intake, patient access, prior authorization support, insurance verification, or a related healthcare operations role • Experience working with commercial and government payers, including Medicare and Medicaid • Knowledge of medical terminology and clinical documentation • Familiarity with referral management, insurance verification, and authorization workflows • Experience using EMR, practice management, or healthcare workflow systems • Proficiency with Microsoft Outlook and Excel • Ability to independently validate information rather than relying solely on automated outputs • Ability to investigate discrepancies and find solutions • Ability to balance speed with accuracy • Ability to stay organized while managing multiple work queues and priorities • Professional communication with providers, clinical teams, and internal partners • Ability to adapt quickly to new systems, workflows, and technologies

🏖️ Benefits

• Medical, Dental, and Vision Coverage • Prescription Drug Coverage and Telemedicine Services • Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), and Flexible Spending Options • 401(k) Retirement Plan with Company Match • Life, AD&D, and Disability Insurance • Accident, Critical Illness, and Hospital Indemnity Coverage • Fertility and Family Planning Support • Tuition Reimbursement and Certification Assistance • Continuing Education and Professional Development Resources • Employee Assistance Program and Wellness Support • Paid Time Off • Volunteer Time Off and Charitable Giving Match • Employee Referral Bonus Program • Full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits