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Patient Referral Coordinator

USA - MA - Remote, United States

Teladoc Health is a global, whole person care company made up of a diverse community of people dedicated to transforming the healthcare experience. As an employee, you’re empowered to show up every day as your most authentic self and be a part of something bigger – thriving both personally and professionally. Together, let’s empower people everywhere to live their healthiest lives.

Summary of Position:

Teladoc Health is transforming how people access and experience healthcare. Recognized as the world leader in virtual care, we are partnering with over a thousand clients to serve hundreds of thousands (soon millions!) of people living with chronic conditions every day. Teladoc Health offers a whole person virtual care platform that empowers all people everywhere to live their healthiest lives by transforming the healthcare experience, from acute and primary care to chronic care, mental health, and specialty care. Our team of data scientists aggregate and interpret substantial amounts of health data and information to create actionable, personalized, and timely health signals for our members. This approach delivers better clinical and financial outcomes while creating a different and better healthcare experience for people everywhere.

The Patient Referral Coordinator will be the system navigator and point of contact to assist members with telehealth case management and ensure referrals are properly sourced and processed accurately, with a focus on customer service. In this role, the Patient Referral Coordinator will interact directly with members, clinical staff, insurance, and medical office personnel to verify approval requirements are met and to provide support addressing health insurance issues that may arise.

Responsibilities:

  • Search the Teladoc Health database and other tools to provide a list of physicians appropriate to each members' clinical condition, geographic location, and preferences that are in network and considered high quality

  • Complete prior authorization and pre-authorization requests in multiple internal and external systems

  • Perform all pertinent quality checks and investigations

  • Ensure that each members' request is completed accurately and fulfilled in a timely manner

  • Identify and escalate complicated or difficult requests to clinical staff to ensure high quality results

  • Research and manage case requests independently and collaboratively

  • Act as internal resource to locate physicians other service processes

  • Effectively manage special projects and other duties as assigned

  • Deliver on the Teladoc Health Corporate Values

The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs.

Qualifications Preferred for Position

  • Post-secondary diploma/degree preferred

  • Prior Referral …

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