Referral Coordinator

Job Summary and Responsibilities

As our Referral Coordinator, you will partner with patients and clinical teams to navigate the referral process so they can receive timely care and avoid delays in treatment or reimbursement. Everyday you will serve as the primary point of contact for managing the full lifecycle of patient referrals, authorizations, and pre-certifications for testing and surgical procedures.

You will be expected to verify insurance eligibility, secure necessary authorizations, coordinate patient appointments, and provide essential guidance-including cost estimates, benefit information, and pre-visit instructions-to ensure a seamless experience, whether you are assisting patients at the front desk or via phone.

To be successful in this role, you must possess strong attention to detail, proficiency in health insurance verification and medical terminology, and the ability to communicate complex information clearly to patients to ensure their referral needs are fully met.

Job Requirements

Education/Work Experience Requirements

• Successful completion of an accredited medical terminology course(s) or equivalent on the job training, and one year of progressively responsible work experience that would demonstrate attainment of the requisite job

knowledge/abilities.

• Work experience in patient scheduling/registration, insurance verification, referral coordination, financial counseling or related function is preferred.

Job Knowledge/Abilities:

• Knowledge of clinic referral and scheduling processes and insurance billing/authorization requirements.
• Knowledge of federal and state payor requirements, including Medicare, DSHS, HMO/PPO Contracts.
• Knowledge of the meaning and usage of medical terminology, abbreviations and coding protocols (e.g., ICD-10) sufficient to perform the duties of the position.
• Knowledge of the functionality and use of automated registration and billing systems (e.g., Cerner) sufficient to perform the duties of the position.
• Ability to learn and ensure compliance with all state and federal regulatory insurance mandates, laws and policies (e.g., WAC, HIPAA, CMS, WSHA) as appropriate within designated scope of authority.
• Ability to read, understand and accurately apply new regulations, business contracts, policies, procedures and technical manuals as appropriate within designated scope of responsibility.
• Ability to rapidly prioritize tasks with accuracy and consistency, and to perform multiple activities simultaneously.
• Ability to communicate effectively and to maintain strict confidentiality of information.
• Ability to read, understand and communicate in English sufficient to perform the duties of the position.
• Ability to use office equipment and automated systems/applications/software at an acceptable level.
• Ability to establish and maintain effective working relationships as required by the duties of the position.

Where You'll Work

Virginia Mason Franciscan Health brings together two award winning health systems in Washington state - CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.