Referrals Coordinator

Referrals Coordinator

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As our Referral Specialist, you will orchestrate patient access to specialized care by expertly managing all referral and authorization processes. Every day, you will proactively obtain clearances for specialty visits, issue referrals for ancillary services (consults, imaging, labs), and secure approvals for medications, DME, home health, and other vital services. To be successful in this role, you will demonstrate meticulous attention to detail, strong organizational skills, and clear communication to ensure seamless and efficient service delivery for our patients.

• Manage Referrals and Authorizations Process referral orders and pre-authorizations, verify insurance eligibility, and secure approvals for diagnostic testing, procedures, specialty care, therapy, and surgeries before services are provided.
• Coordinate Patient Appointments and Care Services Schedule and coordinate clinic visits, referrals, ancillary services, and related care activities while ensuring all required documentation and authorizations are in place.
• Provide Insurance, Billing, and Financial Guidance Educate patients on insurance benefits, referral requirements, billing processes, cost estimates, and financial policies; escalate complex financial inquiries as appropriate.
• Maintain Accurate Patient Records and Documentation Update electronic medical records, document patient interactions, scan and file records, track referral status, and ensure all information is complete and accurate.
• Communicate and Follow Up with Patients and Care Teams Serve as a liaison among patients, providers, referring clinics, and insurers; notify stakeholders of referral decisions, additional requirements, appointment changes, and missed visits.
• Support Patient Education and Referral-Related Resources Provide pre-visit instructions, educational materials, registration requirements, and coordinate referral-related equipment or resources, including follow-up on equipment returns when applicable.

Required:

• Successful completion of an accredited medical terminology course(s) or equivalent on the job training.
• One year of progressively responsible work experience that would demonstrate attainment of the requisite job knowledge/abilities.

Preferred:

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