Referral Coordinator

Job Details:

PURPOSE

The Referral Coordinator ensures a seamless, patient-centered experience across the healthcare system. This role coordinates appointments, manages inbound and outbound referrals and authorizations, verifies insurance, supports care transitions, and communicates with patients and families to facilitate access to care. The Referral Coordinator serves as a liaison between patients, providers, and specialists, helping resolve scheduling, insurance, and referral-related issues while enhancing operational efficiency and patient satisfaction.

RESPONSIBILITIES

Coordinates Patient Scheduling and Appointments

• Schedules and confirms appointments across multiple specialties.
• Provides pre-visit instructions and coordinates follow-up care.
• Collaborates with clinical teams to optimize scheduling workflows.
• Schedules urgent referrals and procedures as needed.
• Updates scheduling systems with accurate patient information.

Manages Referrals and Authorizations

• Processes inbound and outbound referrals, ensuring timely and accurate documentation.
• Identifies appropriate specialists and coordinates referral logistics.
• Verifies insurance coverage and obtains prior authorizations.
• Tracks referral progress and ensures follow-up care is arranged.
• Communicates referral status to patients and providers.

Supports Care Coordination

• Supports discharge planning and post-visit care transitions.
• Coordinates services such as home health, rehabilitation, or specialty follow-up.
• Communicates care plans to patients and families.
• Ensures continuity of care across settings and providers.
• Monitors patient progress and follow-up needs.

Verifies Insurance and Benefits

• Verifies insurance eligibility and benefits.
• Communicates financial responsibilities and assists with resources.
• Completes prior authorizations for procedures and testing.
• Resolves coverage issues in collaboration with billing teams.
• Updates insurance information in the EMR.

Provides Patient Communication and Support

• Responds to patient inquiries via phone, portal, or in person.
• Educates patients on care processes, referrals, and expectations.
• De-escalates concerns and escalates clinical issues appropriately.
• Maintains confidentiality and professionalism in all interactions.
• Provides timely updates and support throughout the care journey.

Maintains Documentation and Compliance

• Maintains accurate records in EMR and scheduling systems.
• Scans and uploads documents to patient records
• Ensures compliance with HIPAA and organizational policies.
• Audits documentation for completeness and accuracy.
• Supports data collection for reporting and quality initiatives.

REQUIRED QUALIFICATIONS

• High school diploma or GED.
• 2 years of experience in a healthcare or patient-facing administrative role.
• Experience with medical terminology and insurance verification.
• Relevant education or experience may be substituted as appropriate.

PREFERRED QUALIFICATIONS

• Associate's or Bachelor's degree in healthcare administration or a related field.
• 3 years of experience in patient coordination, scheduling, or referrals.
• Experience using electronic medical records (EMR) systems such as Epic.
• Certified Medical Administrative Assistant (CMAA)
• Certified Patient Care Coordinator (CPCC)
• Basic Life Support (BLS) certification

SALARY RANGE

$45,000 + depending on qualifications

WORKING ENVIRONMENT/EQUIPMENT

• Standard office equipment.
• Repetitive use of a keyboard.
• May be exposed to such occupational hazards as communicable diseases, blood borne pathogens, ionizing and non-ionizing radiation, hazardous medications and disoriented or combative patients, or others.

Required Materials

• Resume/CV
• 3 work references with their contact information; at least one reference should be from a supervisor
• Letter of interest