Coordinator, Appointments & Referrals

NeighborHealth•Revere, MA

3d•Onsite

About The Position

The Appointment and Referrals Coordinator is part of NeighborHealth’s patient service team. The role gathers information about patients’ medical needs to schedule appointments and obtains insurance verification for referral approvals. The coordinator serves as a system navigator and point of contact for patients and families, answering questions and addressing concerns. The position may also advocate with insurance carriers to help secure approval for necessary services in a timely manner. The coordinator schedules external specialty visits, communicates appointment outcomes, educates patients about insurance networks and potential out-of-network costs, and processes referrals in accordance with department guidelines. The role requires attention to detail, timely handling of Epic in-basket messages, and the ability to interpret medical terminology and managed care insurance benefits. The position is based at 300 Ocean Avenue in Revere and is scheduled Monday through Friday, 8:00 AM to 5:00 PM.

Requirements

High school diploma or GED.
At least one year of experience in a healthcare setting.
Ability to understand and interpret managed care insurance benefits and guidelines.
Knowledge of medical terminology.
Working knowledge of health center computer systems for registration, billing, appointment scheduling, and managed care options.
Experience with managed care plan electronic or online authorization technology.

Nice To Haves

Related college degree or equivalent work experience.
Fluency in English and Spanish.
Experience with medical terminology.

Responsibilities

Maximize reimbursement to the health center from managed care payors by scheduling specialty appointments appropriately and communicating outcomes to patients and/or specialist offices.
Establish and maintain professional, collaborative relationships with internal and external customers.
Educate patients about their insurance so they can schedule specialty appointments within their insurance network and understand the financial consequences of seeing out-of-network providers.
Provide patients with high-quality customer service consistent with NeighborHealth’s mission and vision.
Review and address Epic in-basket messages promptly, taking action within 24–48 hours of receipt.
Schedule external specialty visits for assigned referral workqueues according to department guidelines, cover other workqueues as needed, and pursue available avenues to secure appointments within requested timeframes.
Follow up with the primary care provider when unable to schedule an appointment as ordered, to explore alternatives.
Interpret medical terminology in referral orders to identify documentation requirements, such as recent laboratory or diagnostic test results.
Process at least 65 referrals per day for BMC workqueues.
Process at least 40 referrals per day for non-BMC referrals.