Cano Health
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Coordinator, Referrals
role at
Cano Health
We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary The Referral Coordinator plays a vital role in supporting patient care coordination by managing insurance pre‑verifications, referral processing, appointment scheduling, and communication between patients, providers, and health plans. This individual ensures timely and accurate handling of all internal and external referrals, authorizations, and follow‑up activities. The Referral Coordinator serves as a key liaison among clinics, specialists, and insurance carriers, while upholding a patient‑centered and service‑oriented approach.
Essential Duties & Responsibilities Referral Management & Coordination
Process outgoing referrals based on provider orders (e.g., specialty care, diagnostics, therapy).
Review, validate, and document referral orders, and input referrals and authorizations into the appropriate data systems.
Schedule appointments with specialists or service providers, prioritizing high‑quality, in‑network, and cost‑effective options.
Track referral status, follow up on incomplete referrals, and ensure timely receipt of consultation reports.
Close the referral loop by ensuring reports and documentation are routed to the appropriate provider.
Patient Communication & Navigation
Educate patients on the referral process, insurance requirements, and expectations.
Assist patients in overcoming logistical or administrative barriers (e.g., transportation, language, scheduling).
Notify patients of appointment details and authorization status.
Provide compassionate, professional support in person and over the phone, reinforcing a positive patient experience.
Insurance & Authorization Processing
Verify insurance eligibility and determine referral and authorization requirements.
Obtain prior authorizations and approvals from health plans as needed.
Collaborate with payers and specialists to expedite authorizations and respond to denials or appeals.
Value‑Based Care Alignment
Proactively schedule referrals related to key quality metrics such as HEDIS, STAR, and QI measures (e.g., mammograms, colonoscopies, diabetic eye exams).
Support accurate and timely documentation to meet risk‑adjustment and quality reporting requirements.
Track referral patterns and guide patients to in‑network or preferred providers aligned with ACOs and narrow‑network strategies.
Identify, address, and expedite referral delays or barriers that may impact clinical outcomes or contractual performance metrics.
Administrative Support & Documentation
Maintain accurate documentation of all referral activities in the Electronic Health Record (EHR) system.
Log referral status, actions taken, and communications in a timely manner.
Generate and distribute referral forms, notifications, and supporting documents.
Care Team Collaboration
Work closely with physicians, nurses, medical assistants, and care managers to coordinate care.
Participate in daily huddles to proactively address upcoming referral needs.
Share referral status updates with clinical team members in real time.
Compliance & Data Privacy
Uphold HIPAA guidelines and clinic protocols related to data handling and patient confidentiality.
Ensure secure communication of patient records to external entities.
Clinic Support & Environment
Provide clerical support to the clinical team, including managing lobby areas and assisting with PPE protocols.
Collaborate with front desk and clinic staff to monitor scheduling and patient flow.
Maintain a welcoming and organized patient experience environment.
Education & Experience
High school diploma or GED required.
Minimum of 1–2 years of experience in a medical office, hospital, or clinical setting handling referrals.
Working knowledge of medical terminology and insurance processes.
Experience with scheduling systems, EHRs (e.g., eClinicalWorks), and insurance authorization procedures.
BLS certification required; must be able to respond appropriately in emergencies.
Required/Preferred Skills
Proficient in Microsoft Office Suite (Excel, Word, Teams, PowerPoint).
Familiarity with insurance portals, including Medicaid, Medicare, and commercial payers.
Bilingual in English and Spanish preferred.
Strong customer service, organizational, and time‑management skills.
Ability to navigate multiple systems such as eClinicalWorks, Availity, Cano.Net, Workday, Oracle, and health‑plan portals.
Behavioral Expectations
Serve as a patient advocate and ensure patient needs are met with empathy and professionalism.
Actively collaborate with clinic teammates to foster a supportive work environment.
Engage with patients respectfully, using preferred names and offering assistance as needed.
Promote a culture of compassion, accountability, and continuous improvement.
Job Requirements Physical Requirements This position works under usual office conditions. The associate is required to work at a personal computer as well as be on the phone for extended periods. Must be able to stand, sit, walk, and occasionally climb. The incumbent must work extended and flexible hours, including weekends as needed. Physical demands include the ability to lift up to 50 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
Travel May involve driving/traveling to assigned clinics/territories (0–25% travel). Flexibility to travel to clinical sites as needed.
Tools & Equipment Computer and peripherals, standard and customized software applications and tools, and usual office equipment.
Disclaimer The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. This is not an all‑inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal‑opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, veteran status, age, or any other characteristic protected by law.
Join our team that is making a difference!
#J-18808-Ljbffr
Coordinator, Referrals
role at
Cano Health
We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary The Referral Coordinator plays a vital role in supporting patient care coordination by managing insurance pre‑verifications, referral processing, appointment scheduling, and communication between patients, providers, and health plans. This individual ensures timely and accurate handling of all internal and external referrals, authorizations, and follow‑up activities. The Referral Coordinator serves as a key liaison among clinics, specialists, and insurance carriers, while upholding a patient‑centered and service‑oriented approach.
Essential Duties & Responsibilities Referral Management & Coordination
Process outgoing referrals based on provider orders (e.g., specialty care, diagnostics, therapy).
Review, validate, and document referral orders, and input referrals and authorizations into the appropriate data systems.
Schedule appointments with specialists or service providers, prioritizing high‑quality, in‑network, and cost‑effective options.
Track referral status, follow up on incomplete referrals, and ensure timely receipt of consultation reports.
Close the referral loop by ensuring reports and documentation are routed to the appropriate provider.
Patient Communication & Navigation
Educate patients on the referral process, insurance requirements, and expectations.
Assist patients in overcoming logistical or administrative barriers (e.g., transportation, language, scheduling).
Notify patients of appointment details and authorization status.
Provide compassionate, professional support in person and over the phone, reinforcing a positive patient experience.
Insurance & Authorization Processing
Verify insurance eligibility and determine referral and authorization requirements.
Obtain prior authorizations and approvals from health plans as needed.
Collaborate with payers and specialists to expedite authorizations and respond to denials or appeals.
Value‑Based Care Alignment
Proactively schedule referrals related to key quality metrics such as HEDIS, STAR, and QI measures (e.g., mammograms, colonoscopies, diabetic eye exams).
Support accurate and timely documentation to meet risk‑adjustment and quality reporting requirements.
Track referral patterns and guide patients to in‑network or preferred providers aligned with ACOs and narrow‑network strategies.
Identify, address, and expedite referral delays or barriers that may impact clinical outcomes or contractual performance metrics.
Administrative Support & Documentation
Maintain accurate documentation of all referral activities in the Electronic Health Record (EHR) system.
Log referral status, actions taken, and communications in a timely manner.
Generate and distribute referral forms, notifications, and supporting documents.
Care Team Collaboration
Work closely with physicians, nurses, medical assistants, and care managers to coordinate care.
Participate in daily huddles to proactively address upcoming referral needs.
Share referral status updates with clinical team members in real time.
Compliance & Data Privacy
Uphold HIPAA guidelines and clinic protocols related to data handling and patient confidentiality.
Ensure secure communication of patient records to external entities.
Clinic Support & Environment
Provide clerical support to the clinical team, including managing lobby areas and assisting with PPE protocols.
Collaborate with front desk and clinic staff to monitor scheduling and patient flow.
Maintain a welcoming and organized patient experience environment.
Education & Experience
High school diploma or GED required.
Minimum of 1–2 years of experience in a medical office, hospital, or clinical setting handling referrals.
Working knowledge of medical terminology and insurance processes.
Experience with scheduling systems, EHRs (e.g., eClinicalWorks), and insurance authorization procedures.
BLS certification required; must be able to respond appropriately in emergencies.
Required/Preferred Skills
Proficient in Microsoft Office Suite (Excel, Word, Teams, PowerPoint).
Familiarity with insurance portals, including Medicaid, Medicare, and commercial payers.
Bilingual in English and Spanish preferred.
Strong customer service, organizational, and time‑management skills.
Ability to navigate multiple systems such as eClinicalWorks, Availity, Cano.Net, Workday, Oracle, and health‑plan portals.
Behavioral Expectations
Serve as a patient advocate and ensure patient needs are met with empathy and professionalism.
Actively collaborate with clinic teammates to foster a supportive work environment.
Engage with patients respectfully, using preferred names and offering assistance as needed.
Promote a culture of compassion, accountability, and continuous improvement.
Job Requirements Physical Requirements This position works under usual office conditions. The associate is required to work at a personal computer as well as be on the phone for extended periods. Must be able to stand, sit, walk, and occasionally climb. The incumbent must work extended and flexible hours, including weekends as needed. Physical demands include the ability to lift up to 50 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
Travel May involve driving/traveling to assigned clinics/territories (0–25% travel). Flexibility to travel to clinical sites as needed.
Tools & Equipment Computer and peripherals, standard and customized software applications and tools, and usual office equipment.
Disclaimer The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. This is not an all‑inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal‑opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, veteran status, age, or any other characteristic protected by law.
Join our team that is making a difference!
#J-18808-Ljbffr