PCP Referral Specialist

Scope of Services:

• Work through a high-volume queue of patients requiring PCP referrals before beginning cardiac rehabilitation.
• Contact PCP offices via phone, fax, portal, and other approved channels to request and follow up on referrals.
• Verify that received referrals contain required information and documentation.

Referral Troubleshooting:

• Investigate why individual referrals are delayed or unable to be completed.
• Navigate common PCP-office barriers such as missing requests or incorrect fax numbers.
• Communicate with patients when their assistance is needed to facilitate the referral process.

Insurance Benefits & Prior Authorization Support:

• Complete insurance eligibility and benefits verification for patients.
• Determine whether prior authorization is required and initiate follow-up.
• Accurately document insurance benefits and authorization outcomes.