Referral Coordinator

InnovaCare Health•New Braunfels, TX

About The Position

The Referral Coordinator collaborates with patients to assess, facilitate, plan, and advocate for their individual health needs. The role applies relationship-building, communication, critical analysis, planning, organization, and patient and family autonomy skills, along with knowledge of funding resources, services, and clinical standards and outcomes. The coordinator tracks and documents referrals, supports accurate patient registration, gathers and shares clinical information with specialists, and helps ensure insurance and prior-approval requirements are met. The role also guides patients and families through referral expectations and potential healthcare, financial, or social barriers, serves as a point of contact, coordinates with service providers, and keeps primary care records current. The position follows the Code of Conduct and HIPAA guidelines.

Requirements

High school diploma; medical assistant certification may sometimes be combined with this qualification.
Strong customer-service focus.
Effective verbal and written communication skills.
Teamwork orientation.
Organized and able to manage competing priorities.
Good judgment.
Resourcefulness in problem solving.
Ability to accept delegated tasks, follow through, and be accountable.

Nice To Haves

Bilingual skills, preferably English and Spanish.

Responsibilities

Maintain ongoing referral tracking and documentation to support team awareness and patient safety, potentially using an IT database.
Ensure complete and accurate patient registration, including demographic and current insurance information.
Gather information about patients’ clinical backgrounds and referral needs, and provide appropriate clinical information to specialists according to referral guidelines.
Contact review organizations and insurance companies to ensure prior-approval requirements are met.
Present necessary medical information, including history, diagnosis, and prognosis.
Provide medical information to financial services to help maximize reimbursement for the hospital and physicians.
Review referral details and expectations with patients.
Help patients address healthcare-system, financial, or social barriers, including arranging interpreters, transportation services, or prescription assistance as appropriate.
Serve as a system navigator and point of contact for patients and families, enabling them to ask questions and raise concerns.
May advocate with carriers to secure timely approval of necessary patient supplies or services.
Identify and use cultural and community resources.
Establish and maintain relationships with identified service providers.
Ensure referrals are addressed in a timely manner and remind patients of scheduled appointments by mail or phone.
Keep the patient’s primary care chart up to date with information about specialist consultations, hospitalizations, emergency-room visits, and community organizations related to their health.
Understand and follow the Code of Conduct and HIPAA guidelines.