Referral Coordinator II

North Shore Community Health•Salem, MA

29d•Hybrid

About The Position

The Referral Coordinator II is responsible for managing the specialty referral process when a provider identifies a higher level of care is needed. This role plays a critical part in facilitating seamless transitions of care for patients in need of specialty care, ensuring they receive appropriate support and resources throughout their healthcare journey. Reporting to the Manager of Patient Experience, the position is responsible for coordinating referrals for complex cases that require careful attention and follow-up, while also engaging directly with patients to address challenges and support communication with specialists across the North Shore region.

Requirements

Demonstrated reliability, good attendance, and positive attitude
Detail-oriented with strong organizational and follow-up skills
Ability to utilize advanced reporting tools and data to inform decision-making and improve outcomes
Strong problem-solving skills to manage complex patient needs and referrals
Warm and professional telephone manner with patience and good memory
Ability to multi-task and work effectively in a fast-paced environment
Courteous, efficient, and effective communication with patients, specialists, and colleagues
Strong interpersonal and communication skills, with the ability to mentor junior staff
Competency with Microsoft Office Suite; proficiency with EPIC and other healthcare technology platforms is a plus
Ability to maintain strict adherence to confidentiality policies
Commitment to incorporating North Shore Community Health’s mission and values into daily activities
Flexibility regarding work assignments and patient needs
High School diploma or equivalent required
Minimum of two (2) years of customer service experience, preferably in a medical setting
Prior experience with referral coordination or patient navigation strongly preferred
All employees must be vaccinated against COVID-19 as a condition of their employment unless they have been granted a religious or medical exception.

Nice To Haves

associate degree or additional training in healthcare administration or related field preferred
Bilingual in Spanish/Portuguese and English preferred

Responsibilities

Oversee the referral coordination to specialty services.
Coordinate appointments for specialty services as requested by the ordering provider.
Collect proper supporting data for each referral before sending it to the specialist.
Provide feedback to the manager and/or care team.
Be the point of contact for hospitals and specialty offices.
Respond to inquiries as to the status of the referral by assessing the request and evaluating the circumstances to provide the correct information.
Verify insurance and obtain prior authorizations with insurance companies via phone, in writing, or electronically.
Inform patient of appointment date, time, and required documentation needed prior to appointment.
Provide patient instructions prior to appointment.
Review work queues on a weekly basis to ensure the patient kept his/her appointment.
Open and review flags regarding consults.
Document entry in EMR as a non-billable encounter and enter the specialty appointment in the referral log.
Log any no-shows and flag the referring physician for follow-up with the patient.
Direct patient to outside resources when needed as requested by primary care physician.
Keep patient information private and communicate professionally with everyone involved in the referral process.