Referral and Authorization Coordinator

Referral and Authorization Coordinator

Are you searching for a meaningful career with competitive pay and exceptional benefits? If so, Northwest Michigan Health Services, Inc. (NMHSI) is the place for you!

For more than 50 years, NMHSI—a nonprofit community health center—has proudly served communities across Northwest Michigan. We are seeking a detail-oriented and patient-focused Referral and Authorization Coordinator to join our team.

About the Role

The Referral and Authorization Coordinator is responsible for coordinating referrals and obtaining prior authorizations to ensure patients receive timely access to specialty, diagnostic, therapeutic, and community-based services.

This position works collaboratively with providers, clinical staff, patients, insurance companies, and community partners to streamline referral workflows, monitor referral completion, obtain required authorizations, and remove barriers to care. Through effective coordination and communication, this role supports continuity of care, improves patient outcomes, and advances NMHSI's quality initiatives.

View full job description for more details.

Key Responsibilities

Referral Coordination

• Coordinate referral activities across all NMHSI locations
• Receive, review, process, and track incoming and outgoing referrals
• Coordinate specialty, diagnostic, imaging, therapy, procedural, and community-based referrals
• Schedule appointments with outside providers when needed
• Communicate referral status and updates with providers, staff, and patients
• Monitor referrals through completion, ensuring consult notes, imaging reports, procedure reports, and specialist recommendations are received and incorporated into the patient's medical record
• Follow up on overdue referrals and unresolved appointments
• Monitor referral completion rates and identify opportunities to improve patient access

Prior Authorization Management

• Obtain insurance prior authorizations for diagnostic imaging, procedures, specialty services, therapies, and durable medical equipment (when applicable)
• Submit clinical documentation to support authorization requests
• Track authorization approvals, denials, and expiration dates
• Coordinate peer-to-peer review requests with providers as needed

Workflow Improvement & Collaboration

• Train staff on referral and authorization processes and best practices
• Create and maintain referral databases and tracking tools
• Identify and utilize appropriate community resources to support patients
• Collaborate with providers, clinical teams, insurance companies, and community partners to improve referral workflows and patient outcomes
• Perform other duties as assigned

Qualifications

Education & Experience

• Bachelor of Science or Associate's degree in a clinical science or related healthcare field OR a minimum of two (2) years of experience in a related field
• Two (2) or more years of ambulatory care experience
• Experience working with patients managing chronic illnesses
• Experience in a community health or Federally Qualified Health Center (FQHC) setting preferred

Skills & Abilities

• Experience with data compilation and analysis
• Knowledge of medical terminology
• Experience with quality improvement initiatives
• Strong organizational skills with exceptional attention to detail
• Ability to prioritize multiple tasks and manage competing deadlines
• Intermediate computer proficiency and experience with healthcare technology systems
• Excellent communication, problem-solving, and interpersonal skills
• Ability to work independently while collaborating effectively with multidisciplinary teams

Additional Requirements

• Current Basic Life Support (BLS)/CPR certification
• Commitment to providing exceptional patient service and supporting access to high-quality healthcare

Why Join NMHSI?

As a team member with NMHSI, you become eligible for an outstanding benefits package 30 days after employment, including:

Health & Insurance Benefits

• Medical benefits through BCBS of Michigan or BCN
• Health Savings Account (HSA) with employer contribution
• Employer-sponsored group term life insurance
• Employer-sponsored short-term and long-term disability insurance
• Employee Assistance Program (available immediately)
• Voluntary life insurance options

Paid Time & Work–Life Balance

• 11 paid holidays
• Generous Paid Time Off (PTO)

Retirement Benefits

• 401(k) with Roth option and employer match

Join Our Mission-Driven Team

If you enjoy coordinating patient care, solving problems, collaborating with healthcare teams, and helping patients access the services they need, we encourage you to apply.

Northwest Michigan Health Services, Inc. is an equal opportunity employer.