Referrals Coordinator

Franciscan Medical Group•Federal Way, WA

6d•$26 - $38

About The Position

As a Referral Specialist, you will manage patient referrals and authorization processes to help patients access specialized care. The role includes obtaining clearances for specialty visits; issuing referrals for ancillary services such as consultations, imaging, and laboratory tests; and securing approvals for medications, durable medical equipment, home health, and other services. Success requires attention to detail, organizational skills, and clear communication to support efficient patient service. The position also coordinates clinic visits and ancillary services, communicates with patients and healthcare teams about referrals, insurance, and routine billing questions, and maintains accurate patient records. It provides patients with referral-related instructions and pre-visit materials, and coordinates the purchase or rental of medical equipment when relevant.

Requirements

Successful completion of accredited medical terminology course(s) or equivalent on-the-job training, upon hire.
One year of progressively responsible work experience demonstrating the required job knowledge and abilities.

Nice To Haves

Work experience in patient scheduling/registration, insurance verification, referral coordination, financial counseling, or a related function.

Responsibilities

Process referral orders and/or pre-authorizations.
Ensure insurance eligibility checks are completed for referrals before patients are seen, either by escalating to the Insurance Verifier or checking eligibility directly.
Complete referrals and/or pre-authorizations before patients are seen for diagnostic testing, therapy, surgeries, procedures, and specialty care, according to requirements and patient preferences.
Explain health plan policies and procedures to patients, employees, and physicians.
Answer patient questions about billing and insurance, obtain cost estimates when requested, and explain insurance benefit coverage.
Notify physicians and patients when referrals are denied or when a second opinion or additional information is needed.
Update patient medical records and copy or scan documents into the appropriate location in the electronic medical record.
Interact with referring clinics as needed to coordinate patient care.
Coordinate patient clinic visits based on authorized referrals and established standards and procedures.
Gather and document insurance eligibility information, perform routine verifications, and enter data in the patient’s electronic medical record as appropriate.
Contact patients to confirm referral appointments and follow up to reschedule missed or cancelled appointments.
Document reasons for patient no-shows and notify management when a policy violation requires further action.
Provide basic information about billing and insurance matters, obtain non-complex cost estimates when requested, and refer more complex cost estimate or benefits questions to a Financial Counselor.
Coordinate patient instructional and educational activities related to referrals with clinic teams, patients, and/or employers.
Provide information about referral appointments and services, testing, financial policies, registration requirements, and relevant educational opportunities.
Prepare and send pre-visit materials suited to the type and nature of the appointment in a timely manner.
Coordinate the purchase of materials and/or rental of medical equipment relevant to patient referrals.
Follow up with patients when medical equipment is due to be returned.