Summit Spine & Joint Centers
Referral & Care Coordination Specialist
Summit Spine & Joint Centers, Lawrenceville, Georgia, United States, 30243
Company Overview
Summit Spine and Joint Centers (SSJC) is on track to become the largest comprehensive spine and joint care provider in the Southeast, with over 45 clinic locations across GA, NC, SC, and TN. SSJC offers clinical, surgical, and imaging services to our patients, and we are seeking qualified individuals to join our team to help deliver exceptional care and support across our growing network!
Job Description Summary The Referral & Care Coordination Specialist is responsible for managing, obtaining, and tracking primary care referrals required for Interventional Pain services. This role serves as the primary liaison between the interventional pain clinic and external primary care offices, payers, and patients to ensure timely access to care and prevent claim denials due to missing referrals. This job is a full‑time, benefited position that reports to the Director of Administrative Operations. Your assigned location will be in Lawrenceville, GA.
Responsibilities
Identify patients requiring PCP referrals prior to specialty visits or procedures and proactively contact PCP offices to request, obtain, and follow up on referrals.
Verify referral requirements by payer and plan (UHC, Humana, Aetna, etc.).
Submit, track, and confirm referrals through payer portals and EMR systems, ensuring referrals are in place prior to the date of service.
Act as the main point of contact for PCP office staff regarding referral requests, providing clear referral requirements and documentation needs.
Maintain professional, persistent follow‑up to minimize scheduling delays.
Inform patients of referral requirements and status, serving as a patient advocate to help navigate the payer and PCP process.
Accurately document referral status in the electronic medical record, ensuring referral logs and tracking tools are appropriately maintained to ensure compliance with all legal and payor rules and requirements.
Perform additional duties as assigned.
Skills And Abilities
Strong customer service skills.
Ability to become a core trainer and super user of EHR (eClinicalWorks).
Excellent verbal and written communication skills in English; multilingual preferred.
Education And Experience
Experience working with PCP offices and payer portals required; experience within an interventional pain specialty preferred.
Experience using eClinicalWorks preferred.
1-3 years of clinical experience required, focusing on referrals, care coordination, or prior authorization; experience with CMS & HMO plans preferred.
Seniority level Entry level
Employment type Full‑time
Job function Health Care Provider
Industries Medical Practices
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Job Description Summary The Referral & Care Coordination Specialist is responsible for managing, obtaining, and tracking primary care referrals required for Interventional Pain services. This role serves as the primary liaison between the interventional pain clinic and external primary care offices, payers, and patients to ensure timely access to care and prevent claim denials due to missing referrals. This job is a full‑time, benefited position that reports to the Director of Administrative Operations. Your assigned location will be in Lawrenceville, GA.
Responsibilities
Identify patients requiring PCP referrals prior to specialty visits or procedures and proactively contact PCP offices to request, obtain, and follow up on referrals.
Verify referral requirements by payer and plan (UHC, Humana, Aetna, etc.).
Submit, track, and confirm referrals through payer portals and EMR systems, ensuring referrals are in place prior to the date of service.
Act as the main point of contact for PCP office staff regarding referral requests, providing clear referral requirements and documentation needs.
Maintain professional, persistent follow‑up to minimize scheduling delays.
Inform patients of referral requirements and status, serving as a patient advocate to help navigate the payer and PCP process.
Accurately document referral status in the electronic medical record, ensuring referral logs and tracking tools are appropriately maintained to ensure compliance with all legal and payor rules and requirements.
Perform additional duties as assigned.
Skills And Abilities
Strong customer service skills.
Ability to become a core trainer and super user of EHR (eClinicalWorks).
Excellent verbal and written communication skills in English; multilingual preferred.
Education And Experience
Experience working with PCP offices and payer portals required; experience within an interventional pain specialty preferred.
Experience using eClinicalWorks preferred.
1-3 years of clinical experience required, focusing on referrals, care coordination, or prior authorization; experience with CMS & HMO plans preferred.
Seniority level Entry level
Employment type Full‑time
Job function Health Care Provider
Industries Medical Practices
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