Referral Coordinator

Job Description

Job Description

Our Core Values:

The culture at Prism Health North Texas is built on our shared Core Values. We make hiring, firing, promotion, and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values:

• We are solution seekers.
• We have a can-do attitude.
• We are mission-driven.
• We care about people.

The Referral Coordinator provides services related to medical referrals and orders to outside providers and organizations.  They also complete medication prior authorizations and works with the prior authorization team to support appeals and denials and is committed to the provision of patient centered/patient valued care.

• Coordinates the completion of medical referrals to outside providers, specialists, imaging centers, or other medical facilities by identifying providers and facilities that are in network with the patient’s insurance; sending referrals and appropriate medical information, communicating with receiving facility and patient to ensure appointments are scheduled; and following up with patient and facilities to obtain records.
• Coordinates referrals to Parkland and other facilities who provide services to uninsured patients.
• Maintains a database of providers who accept various insurance plans
• Communicates with patients regarding any barriers to completing outside appointments and works with staff, providers, financial team, case management or other resources to overcome barriers to care.
• Coordinates with providers, clinic, and finance staff to complete medication prior authorizations and appeals, as needed.
• Completes the care loop by continuously updating patients and providers with the status of medical referrals and / or medication prior authorizations.
• Serves as a patient advocate, focusing on patient needs, patient rights, confidentiality, and religious and cultural preferences. Assists in communicating these needs and preferences to the assigned clinical team.
• Maintains accurate and timely documentation of all activities performed.
• Other duties as assigned.

• Must be able to communicate effectively with patients, families, and Agency staff at all levels.
• Must be experienced with Microsoft Excel, Word, Outlook, Teams and data entry. Electronic medical records (EMR) experience preferred.
• Must have excellent organizational skills and ability to complete task independently.
• Bilingual preferred.

• High school diploma or G.E.D.
• Previous experience with referral coordination and prior authorizations preferred