Outside Referral Coordinator

We are seeking a detail-oriented, patient-focused Outside Referral Coordinator to join our dedicated healthcare team. In this role, you will serve as a vital link between healthcare providers, members, and clinical teams. You will handle inbound calls, gather clinical and administrative details, and process prior authorization requests with accuracy and empathy.

Working in a high-volume call management setting, you will navigate policy guidelines, verify coverage criteria, and provide real-time updates while maintaining exceptional service standards. The ideal candidate brings strong reading comprehension, sharp attention to detail, and a dependable, patient-first mindset.

Learn more about the general tasks related to this opportunity below, as well as required skills.

• Position Type: 3-Month Contract (Opportunity for extension; eligible to apply for permanent positions while on contract)
• Pay Rate: Starts at $28.00 / hour
• Location: 100% On-Site | Renton, WA 98057
• Schedule: Monday – Friday, 8:00 AM – 5:00 PM

Key Responsibilities

• Prior Authorization Intake: Conduct prior authorization intake by phone with providers and members, accurately entering data into EPIC Tapestry UM.
• Status Updates & Customer Service: Provide prompt, professional status updates on authorization requests while delivering exceptional customer service.
• Benefits & Coverage Review: Review benefits, coverage criteria, and documentation guidelines across a variety of medical request types.
• Call Workflow Management: Efficiently manage high-volume call workflows, spending 6+ hours of an 8-hour shift handling live inquiries.

Qualifications & Skills

• Education: High School Diploma or GED required; Associate degree or higher preferred.
• Experience: 3+ years of related experience in healthcare customer service, intake, or prior authorization.
• Technical Systems: Required proficiency with EPIC (specifically Tapestry UM), Cisco/Finesse phone systems, referral management systems, and MS Outlook.
• Knowledge Base: Preferred experience with Utilization Management (UM), CMS guidelines, medical terminology, and anatomy & physiology. xhyhwjd
• Core Competencies: Strong reading comprehension, sharp attention to detail, and professional phone etiquette to ensure a positive member experience.