Role Description The Referral Coordinator supports Clinical teams, Patients and Family Members by managing referrals and/or authorizations for the Medical Group. They are responsible for processing Internal and External referrals and authorizations from orders prescribed by the provider in the Electronic Health Record (EHR) system within the Outpatient Ambulatory setting. Responsibilities - Completes entry of referrals and/or authorizations into EHR. - Coordinates follow-up care with the referral as the referral expires. - Responsible to schedule various appointments associated with the referral, diagnostic testing, and surgical procedures. - Ensures financial information and insurance has been verified. - Ensures Primary Care provider is accurate based on payer guidelines. - Updates patient insurance information in EHR systems as needed. - Initiates the referral and authorization process for visits and services. - Works closely with nursing and medical staff to facilitate optimal patient care. - Communicates with the scheduling department to verify each patient’s insurance requirements have been satisfied for upcoming appointments. - Coordinates with other departments as needed to facilitate patient’s visit. - Coordinates with Patients when necessary to complete referral. - Provides peer to peer training and new hire preceptor. - Provides patient with referral information for physicians and facilities. - Communicates effectively with all internal and external customers – PCP, Patient, clinical departments, etc. in order to obtain the required authorization needed for each visit or service. - Maintains working knowledge of ICD-10 and CPT codes. - Maintains current knowledge of referral and authorization requirements based on payer specific guidelines. - Demonstrates a basic knowledge of third party reimbursement requirements and regulations. - Exhibits competency in the use of registration systems, electronic verification tools, and Web-based resources. - Serves as a resource for the department of referring provider options. - Understands the importance Orlando Health places on providing exemplary customer service. - Performs job in a manner that helps meet customer service goals. - Demonstrates a positive and professional approach and communicates effectively with customers and team members at all times. - Contributes suggestions for improving workflow and productivity. - Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards. - Maintains flexibility in work schedule availability that allows department to change/modify work schedule to meet departmental needs. - Basic understanding of how the referral role affects the Organization’s Initiatives and goals. - Maintains compliance with all Orlando Health policies and procedures. Qualifications - High school graduate. - Medical Terminology. - Three (3) years of directly related work experience. - Experience in processing physician office and/or hospital referrals. - Proficient in Windows Microsoft Office based products (Word, Excel, and Power Point). - Proficient in PC/Windows experience. Benefits - Health/Dental/Vision/Life Insurance. - Student loan repayment. - Tuition reimbursement. - FREE college education programs. - Retirement savings. - Paid paternity leave. - Fertility benefits. - Back up elder and childcare. - Pet insurance. - PTO/Holidays. - More for full time and part time employees.

• Coordinate the System Pharmacy & Therapeutics Committee. • Support the coordination of supporting subcommittees (including Infusion Center P&T, Ambulatory P&T, and Antimicrobial Stewardship reporting pathways). • Maintain the operating cadence, agendas, and standardized review processes that support effective formulary and medication-use governance across the system. • Ensure multidisciplinary input is appropriately captured, documented, and elevated through established governance pathways. • Coordinate enterprise formulary review processes, including intake, documentation, and presentation of clinical, operational, and economic considerations. • Ensure consistent application of formulary, therapeutic interchange, and medication-use policies across inpatient, infusion, and ambulatory settings. • Support ongoing maintenance and evolution of the system formulary in alignment with evidence, safety considerations, and stewardship goals.

• Collects and reviews all data to the degree authorized by the SOP of the program. • Coordinates services with the specialty pharmacy and national account manager. • Maintains frequent phone contact with pharmacy staff and manufacturer client. • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. • Provides training and support to inter-departmental associates. • Verifies transactions and processes comply with organizational and departmental policies and procedures; suggests changes and solutions as appropriate. • Independently and effectively resolves complex accounts with minimal supervision. • Demonstrates an understanding of complicated data issues. • Handles complex issues where analysis of situations or data requires an in-depth evaluation of variable factors. • Exercises judgment in selecting methods, techniques and evaluation criteria for obtaining results of pending shipments and incomplete data sets. • Networks with key contacts outside own area of expertise. • Acts independently to determine methods and procedures on new or special assignments. • Performs related duties and special projects as assigned. • Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled. • Performs other related duties as assigned.

• Coordinating prior authorizations, insurance verifications, medication approvals, and medical service approvals • Working closely with providers, pharmacies, insurance companies, and internal clinical or billing teams to obtain required approvals • Resolving authorization issues, and maintaining complete documentation • Frequent computer use, phone communication, insurance portal access, and coordination with multiple departments • This position typically reports to their Regional Manager, DOD Operations Manager, or Project Manager