Center Care Team - Referral Coordinator

ArchWell Health•Birmingham, AL

About The Position

The Referral Coordinator supports members as they navigate the healthcare delivery system, helping ensure they receive appropriate care in the right setting. The coordinator guides members and their families in connecting with specialists inside or outside the center in a timely manner. The role calls for a strong understanding of the healthcare ecosystem, attention to detail, and a commitment to quality care for seniors.

Requirements

Deep understanding of the healthcare ecosystem, ideally including benefits and insurance authorization.
Passion for helping senior members carry out care plans.
Ability to work effectively with diverse populations, including staff, providers, members, family members, insurance carriers, vendors, and the public.
Basic medical terminology.
Understanding of Medicare criteria for equipment and supplies.
Knowledge of CPT and ICD-10 codes.
Working knowledge of specialists and community resources.
Strong communication and rapport-building skills within an interdisciplinary team.
Ability to multitask and manage competing priorities with strong attention to detail.
Proficiency with PCs, including Microsoft Office.
High school diploma or equivalent.
Two years of experience in referral management or care coordination.

Nice To Haves

Degree or college-level coursework in healthcare.
Medical Assistant or medical administrative experience.
Experience with EMR systems, ideally eClinicalWorks or similar.
Fluency in Spanish or languages spoken in the communities served, where necessary.

Responsibilities

Partner with ArchWell Health’s multidisciplinary care team to understand each member’s care needs and identify gaps and barriers to treatment.
Coordinate referrals to external providers, vendors, and services.
Complete and maintain accurate, current documentation for member referrals.
Build relationships with members and their families to facilitate care coordination.
Carry out activities and ongoing monitoring outlined in members’ care plans, supporting follow-up and progress toward care plan goals.
Adhere to HIPAA standards and protect the confidentiality of protected health information.
Promote clear communication among the care team and treating clinicians.
Help members address healthcare-system issues and financial or social barriers, such as arranging interpreters, transportation services, or prescription assistance.
Serve as the system navigator and point of contact for members and families, providing access to ask questions and raise concerns.
Perform additional duties as assigned.