Responsibilities

The Pre-Service Coordinator will be responsible for all aspects of referral management, including reviewing inbound referrals and correspondence, screening physician’s orders and documentation, requesting additional information when necessary, performing verification of benefits coverage and eligibility, reviewing referral data, providing referral management education to members and providers, coordinating the timely delivery of care and services, communicating with patient, referring entities, providers, and members, and maintaining detailed documentation of patient, physician, referral source, and provider interactions. They will also work with Pre-Authorization, Utilization Management, Billing, Pharmacy, Home Care, and DME regarding referred services, and report ongoing issues with referring entities or providers that delay service delivery to the manager, while ensuring work meets quality standards and providing excellent internal and external customer service.