Senior PCP Referral Expert

Job Title:

Senior PCP Referral Expert

Classification:

1099 Contractor

Work Structure:

Fully Remote

Hours/Schedule:

Monday-Friday; 40-45 hours per week

Team:

Clinical Operations

Reporting to:

Senior Enrollment Operations Manager

Location:

United States

About Us:

One in three people die of heart disease - it's time to change that. We're redesigning heart health from the ground up so that everyone can live fuller lives. Our team consists of mission-driven clinicians, engineers, and professionals attacking a problem using evidence-based research and guidelines for cardiovascular rehabilitation. We’re working to deliver exercise and wellness for the older adult cardiovascular disease using telemedicine. We are dedicated to delivering exceptional services that enhance the lives of our patients.

About the Role:

We are looking for a highly experienced

Senior PCP Referral Expert to support the process of obtaining PCP referrals for patients enrolling in our virtual cardiac rehabilitation program.

This is a high-volume, execution-focused role requiring someone who is persistent, organized, resourceful, and highly experienced in navigating PCP offices and referral processes

. You will follow up directly with PCP offices, track outstanding referral requests, troubleshoot common barriers, and help ensure required referrals are received and approved as quickly as possible.

The ideal candidate has

3+ years of direct experience obtaining PCP referrals

, preferably within a high-volume healthcare environment, and is extremely comfortable navigating PCP offices, referral requirements, insurance processes, and common reasons referrals become delayed or unsuccessful.

While the primary focus of this role is PCP referral follow-up, the contractor may also assist with insurance benefits verification and prior authorization checks based on team and patient needs.

Scope of Services

PCP Referral Follow-Up

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.

Conduct consistent and timely follow-up on outstanding referral requests.

Confirm the status of requests directly with PCP offices rather than relying solely on fax or electronic submissions.

Verify that received referrals contain the required information and documentation.

Follow up with PCP offices when referrals are incomplete, incorrect, unsigned, or otherwise unable to be processed.

Continue appropriate follow-up until a referral is received or a clear outcome is established.

Referral Troubleshooting

Investigate why individual referrals are delayed or unable to be completed.

Navigate common PCP-office barriers, including missing requests, incorrect fax numbers, provider signature requirements, appointment requirements, incorrect referral information, and office-specific workflows.

Identify when additional follow-up or escalation within a PCP office may be appropriate.