Referral Coordinator (multiple vacancies)

Description

Key Responsibilities

• Process and track all incoming and outgoing referrals using NextGen EHR system
• Verify insurance coverage and obtain prior authorizations for services
• Schedule patient appointments when permitted, and coordinate necessary clinical information transfer
• Maintain accurate documentation of all referral activities within NextGen
• Follow up on pending referrals to ensure timely completion
• Communicate with patients regarding referral status, appointment details, and preparation instructions
• Coordinate with specialist offices to confirm referral status, dates of scheduled appointments, and obtain consultant notes for referral completion
• Liaise with insurance companies to resolve coverage issues and denials
• Review referral reports to identify open referrals, ensure timely completion, and close out expired referrals as needed.
• Ensure compliance with HIPAA regulations and organizational policies
• Participate in quality improvement initiatives related to the referral process

Qualifications

• High school diploma/GED required
• 1-2 years of professional experience in a healthcare setting and with insurance authorizations
• Basic knowledge of healthcare terminology
• Strong communication skills, detail oriented with a strong patient service mindset
• Knowledge of 42 Code of Federal Regulations (CFR) Part 2 and HIPAA compliance

Benefits

• Comprehensive medical and dental insurance plans (BCBSRI) with heavy subsidization
• Supplemental vision insurance
• Voluntary medical and dependent care flexible spending accounts
• Up to 3% matching 403(b) retirement plan
• Employer-paid life insurance & long-term disability
• Generous paid time off including vacation, holidays, personal days, and sick time
• Mileage reimbursement
• Tuition reimbursement
• Center-paid training/CEUs opportunities
• Employee assistance program