(505) 555-0127 ◇ Albuquerque, NM
rosetta.galvan@example.com ◇ linkedin.com/in/rosetta-galvan ◇ rosettagalvan.com
Referral coordinator with 8 years in healthcare administration, currently managing specialist referrals for a primary care group with 42 providers and 68,000 patients. Processes about 1,100 referrals a month, cut the average time from order to scheduled appointment from 19 days to 8, and raised insurance authorisation approval on first submission from 81% to 95%. Bilingual in English and Spanish and focused on making sure no patient falls through the cracks.
Coursework in Medical Terminology, Health Insurance, Medical Office Procedures, and HIPAA Compliance.
Scheduling, insurance verification, patient records, and front office procedures.
- Manage about 1,100 specialist referrals a month for 42 providers and 68,000 patients with a team of 4.
- Cut average time from referral order to scheduled appointment from 19 days to 8 with daily triage.
- Raised first-submission authorisation approval from 81% to 95% with payer-specific checklists.
- Processed about 350 referrals and 120 prior authorisations a month for 3 clinic sites.
- Closed 92% of referrals with specialist notes returned to the primary provider within 30 days.
- Handled about 50 bilingual patient calls a day about referral status and next steps.
- Checked in about 80 patients a day and verified insurance for every visit at a 6-provider clinic.
- Cut claim denials for eligibility from 7% to 2% by checking coverage 2 days before visits.
- Scheduled about 60 appointments a day by phone in English and Spanish.
Daily Referral Triage. Set up a daily triage of new referrals by urgency, insurance, and specialist wait times, with a 2-day target to contact patients, which cut average time from order to scheduled appointment from 19 days to 8 and cut urgent referral delays to near 0.
Payer Authorisation Checklists. Wrote checklists of required documents for the 12 most common procedures and 6 main payers, shared with providers and medical assistants, which raised first-submission approval from 81% to 95% and cut rework by about 30 hours a month.
Referral Loop Closure Report. Built a monthly Excel report of open referrals with no specialist notes after 30 days, with follow-up calls to specialist offices, which raised loop closure from 74% to 92%.
- Volunteer at a community health fair, helping about 150 residents a year sign up for health coverage.
- Member of a medical administrative professionals association, attending 4 webinars a year.
- Coach a youth softball team of 12 players at a city recreation league each spring.
- Lead a referral team of 4 coordinators, setting daily work queues and checking quality.
- Trained 20 medical assistants on complete referral orders and authorisation requirements.
- Serve as the practice contact for 30 specialist offices on referral and scheduling issues.

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