Referral Coordinator

UNION COMMUNITY CARE•Lancaster, PA

11d

About The Position

The Referral Coordinator completes prior authorizations and arranges specialty care appointments for patients. The role tracks and follows up on referral orders according to Union Community Care policy and connects patients with resources to help overcome barriers to completing referrals. The coordinator communicates between care teams and specialists, assists patients with accessing appointments, and completes referral documentation and forms. The Referral Coordinator works with patients, specialist offices, and insurance companies to obtain prior authorizations for specialty appointments and diagnostic tests, arrange appointments, and submit required payer documentation. The role maintains knowledge of insurance requirements, referral and prioritization protocols, participating specialist offices, required documentation, and scheduling procedures. The coordinator prioritizes referrals by urgency, keeps providers informed of referral progress, and follows up to close the referral loop. The position also includes other assigned work-related duties and participation in mandatory staff meetings, team meetings, and trainings.

Requirements

High school diploma or GED.
Excellent telephone and customer service skills.
Healthcare experience required.
Ability to track frequently changing information and details about insurance companies, policies, practices, and patients.
Ability to work collaboratively with care teams.
Fluent English communication skills, including reading, speaking, and writing.
Knowledge of medical terminology.

Nice To Haves

Prior referrals experience preferred.

Responsibilities

Coordinate with patients, specialist offices, and insurance companies to obtain prior authorizations for specialty appointments and diagnostic tests.
Coordinate appointments with specialist offices and patients, and submit documentation required by payers to authorize visits.
Keep current with insurance requirements and confirm that needed specialties and specialists are covered by the patient’s insurance.
Follow referral and prioritization protocols for each payer.
Develop working relationships with specialty offices to facilitate referrals.
Maintain current information about specialist offices, participating insurance plans, required documentation, and scheduling procedures.
Prioritize referrals based on urgency.
Communicate with providers about referral progress.
Follow up on referrals and close the referral loop according to policy.
Perform other assigned work-related duties.
Participate in mandatory all-staff meetings, team meetings, and trainings.