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Referral Coordinator

Defendiv Private Security • Fresno, CA, US • published 2026-09-25 21:51:46.165745

Description

**Position Summary:** The Medical Administrator coordinates, processes, and tracks medical referrals for injured workers in compliance with Workers’ Compensation regulations. This role ensures timely access to authorized specialty care while maintaining effective communication among healthcare providers, legal case managers, vendors, administrative staff, and management. The department plays a vital role in facilitating appropriate treatment and ensuring all regulatory and payer requirements are consistently met. **Roles and Responsibilities:** 1\. Receive, review, and process referral requests in accordance with Workers’ Compensation guidelines and payer authorization requirements. 2\. Coordinate appointments for authorized referrals. 3\. Communicate effectively with treating providers, legal case managers, vendors, admins and management. 4\. Track referral status from submission through completion and follow up on pending authorizations or appointments. 5\. Maintain accurate and timely documentation in Affirmative Claims Manager. 6\. Ensure compliance with state Workers’ Compensation laws, utilization review requirements, and internal policies. 7\. Identify and escalate delays, d...

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