Referral Manager at Gastromed, LLC – Coral Gables, Florida
Explore Related Opportunities
About This Position
JOB TITLE: Referral Manager
REPORTS TO: Chief Development Officer
FLSA STATUS: Exempt
JOB SUMMARY:
The Referral Manager is responsible for overseeing the daily operations of the referral and procedure authorization department to ensure timely scheduling, accurate insurance verification, and appropriate referral authorizations for all procedures. This role leads, supervises, and develops department staff to ensure compliance with payer requirements, minimize claim denials, and maintain efficient scheduling workflows across all facilities.
The Referral Manager works collaboratively with Practice Managers, the Revenue Cycle team, and Surgical Center leadership to ensure procedures are scheduled appropriately and patients receive a high level of service and care coordination.
QUALIFICATIONS/EDUCATION:
- Associate of Arts (A.A) or equivalent experience required; Bachelor’s degree preferred.
- Minimum of 3–5 years of experience in healthcare referrals, authorizations, or patient access operations.
- Minimum 2 years of supervisory or leadership experience required.
- Strong knowledge of insurance verification, prior authorizations, and payer requirements.
- Proficiency in Microsoft Word, Excel, Outlook, and electronic medical record (EMR) systems.
- Bi-lingual English/Spanish required.
ABILITIES/SKILLS:
- Strong organizational, analytical, and problem-solving skills.
- Ability to manage multiple priorities and workflows in a fast-paced healthcare environment.
- Excellent verbal and written communication skills.
- Strong leadership and team development skills.
- Ability to work independently and make sound decisions.
- Ability to collaborate effectively with multiple departments and external partners.
- High attention to detail and accuracy.
- Ability to maintain patient confidentiality and comply with HIPAA regulations.
- Professional demeanor and commitment to patient-centered service.
SUPERVISORY RESPONSIBILITIES:
- Directly supervises referral and authorization staff responsible for procedure scheduling and insurance approvals.
- Carries out supervisory responsibilities in accordance with organizational policies and applicable laws.
- Responsibilities include recruiting, interviewing, hiring, training, coaching, counseling, and evaluating employees.
- Assigns and directs workflow to ensure department productivity and efficiency.
- Monitors staff performance and implements corrective action when necessary.
ESSENTIAL DUTIES/ RESPONSIBILITIES:
Referral & Authorization Management
- Oversee the referral and prior authorization process for all procedures scheduled across all facilities.
- Ensure referrals and authorizations are obtained in advance of procedures to prevent claim denials.
- Monitor department performance to ensure authorization timelines are met.
- Ensure patient insurance eligibility and benefits are verified prior to procedures.
Operational Oversight
- Establish, implement, and monitor procedures to improve department workflow and efficiency.
- Monitor daily procedure scheduling volumes and ensure appropriate staffing levels.
- Ensure patients who cancel or miss appointments are promptly rescheduled.
- Monitor departmental productivity and reduce unnecessary overtime.
Revenue Cycle Coordination
- Work closely with the Revenue Cycle Manager to minimize denials related to missing authorizations or referral issues.
- Coordinate with surgical centers to address scheduling or authorization issues.
- Support initiatives that improve revenue integrity and reduce reimbursement delays.
Staff Leadership & Development
- Train, supervise, mentor, and motivate department staff.
- Conduct departmental meetings and ongoing staff training.
- Promote a collaborative and supportive work environment.
- Implement strategies to improve employee satisfaction and reduce turnover.
Communication & Service
- Ensure patient calls, voicemails, and department emails are handled promptly and professionally.
- Prepare reports and correspondence as required.
- Maintain effective communication with physicians, practice managers, and operational leadership.
Administrative Responsibilities
- Manage staff schedules, time and attendance, and PTO approvals.
- Maintain department supplies and operational resources.
- Identify workflow improvements that enhance productivity and patient service.
Additional Duties
- Maintain compliance with organizational policies and regulatory requirements.
- Participate in operational meetings and performance improvement initiatives.
- Perform other duties as assigned by management.
Scan to Apply
Job Location
Job Location
This job is located in the Coral Gables, Florida, 33134, United States region.