Referral Coordinator-SGH

Presbyterian Healthcare Services • Socorro, TX

13d • $17 - $28 • Onsite

About The Position

The Referral Coordinator navigates complex requests from referring providers and their offices, primarily by phone, and develops and maintains positive working relationships with them. The role uses knowledge of the organization and available resources to address requests and concerns, handling calls diplomatically and professionally. It includes advanced scheduling for specialty or radiologic procedures; identifying payer requirements and obtaining prior authorization, certification, or referrals; maintaining scheduling knowledge to review department schedules for accuracy and efficiency; and monitoring in-baskets and reports for overdue results, waitlisted appointments, recalls, and related items.

The coordinator communicates with providers and patients in a timely manner, manages referrals from receipt through completion, enters faxed referrals into the EHR, and guides referring offices through authorization requirements. The role coordinates access across departments, follows up with referring providers on referral status, and supports provider-to-provider communication. It also involves requesting relevant medical records, ensuring required testing is ordered and scheduled, and communicating restrictions that may prevent scheduling as ordered.

This is a full-time, non-exempt position based at PMG - Socorro, with a day shift. The listed compensation range is $16.79 to $27.67. Benefits-eligible employees receive medical, dental, vision, short- and long-term disability, group term life insurance, and optional voluntary benefits. Presbyterian also offers an employee wellness rewards program with opportunities to earn gift cards and other rewards through wellness activities.

Requirements

• High school diploma or equivalent.
• At least 18 months of experience in a medical office setting with significant physician interaction.
• Proficiency in prior authorization, certification, and referral processes.
• Must pass EPIC competency for Registration upon completion of the Epic Clerical Training class.
• Short-term training in medical terminology.
• Working knowledge of CPT and ICD-10 coding.
• Must pass the annual competency exam for all areas of responsibility.
• Strong organizational and multitasking skills.
• Significant customer service skills.
• Ability to function under pressure while maintaining professionalism.

Responsibilities

• Achieve an exceptional experience for providers and referring providers’ offices using CARES, AIDET, and EPE tools.
• Ensure communications with providers and patients occur in a timely manner.
• Communicate with referring providers and their offices to schedule referrals, answer questions, and arrange provider-to-provider communication as needed.
• Address and attempt to resolve concerns and requests in the moment using resources and appropriate escalations.
• Coordinate with departments throughout the program to gain access for referrals.
• Follow up with referring providers to ensure they know the status of their referral or request.
• Maintain knowledge of program operations and processes to guide referring providers, answer questions about potential referrals, and perform appropriate hand-offs.
• Coordinate with the Business Development partner to collect feedback from referring offices and support an exceptional experience.
• Manage conflict and request supervisor assistance when needed.
• Foster effective patient relations with patients, the public, and providers by listening, responding, and escalating when appropriate.
• Work with program providers, testing departments, and health plan representatives to facilitate access for referrals and members.
• Facilitate provider-to-provider communication as requested.
• Coordinate incoming referrals from receipt through completion.
• Enter faxed referrals into the EHR.
• Guide and assist referring offices through prior authorization request requirements and processes.
• Apply knowledge of surgical and procedural scheduling workflows to prepare and hand off referrals appropriately.
• Ensure relevant medical records are requested.
• Ensure required testing is ordered and scheduled.
• Communicate effectively with the ordering clinician when restrictions such as access limit or prevent scheduling as ordered.
• Schedule specialty or radiologic procedures and review department schedules for accuracy and efficiency.
• Monitor in-baskets and reports for overdue results, waitlisted appointments, recalls, and related items.
• Identify payer requirements and obtain prior authorization, certification, or referrals.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term disability insurance
• Long-term disability insurance
• Group term life insurance
• Optional voluntary benefits
• Employee wellness rewards program with opportunities to earn gift cards and other rewards

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED