Referrals Coordinator

CommonSpirit Health•Federal Way, WA

About The Position

The Referrals Coordinator manages patient access to specialized care by handling referral and authorization processes. The role obtains clearances for specialty visits; issues referrals for ancillary services such as consultations, imaging, and laboratory services; and secures approvals for medications, durable medical equipment, home health, and other services. The position requires attention to detail, organizational skills, and clear communication to support efficient patient care. The coordinator processes referral orders and pre-authorizations, verifies insurance eligibility, completes required approvals before services are provided, and communicates coverage and process information to patients, employees, physicians, and members. The role also updates and maintains patient medical records, coordinates appointments and ancillary services, follows up on missed appointments, responds to routine billing and insurance questions, and arranges relevant patient instructions, educational materials, and medical equipment.

Requirements

Successful completion of an accredited medical terminology course 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 or registration, insurance verification, referral coordination, financial counseling, or a related function.

Responsibilities

Process referral orders and pre-authorizations.
Ensure insurance eligibility checks are completed before patients are seen, by escalating to the Insurance Verifier or checking eligibility directly.
Complete referrals and pre-authorizations for diagnostic testing, therapy, surgeries, procedures, and specialty care before the patient is seen, according to requirements and patient preference.
Explain health plan policies and procedures to patients, employees, physicians, and members.
Answer routine patient billing and insurance clarification questions, obtain non-complex cost estimates when requested, and refer complex estimate or benefits questions to a Financial Counselor.
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 correct electronic medical record location.
Coordinate with referring clinics as needed to support patient care.
Coordinate patient clinic visits and ancillary services according to authorized referrals and established procedures.
Gather and document insurance eligibility information, conduct routine verifications, and enter relevant data in the patient’s electronic medical record.
Contact patients to confirm referral appointments and follow up to reschedule missed or cancelled appointments; document no-show reasons and notify management when further action may be needed.
Coordinate patient instructional and educational activities related to referrals, including providing appointment, service, testing, financial policy, and registration information.
Prepare and send appropriate pre-visit materials to patients in a timely manner.
Coordinate the purchase of materials and rental of medical equipment related to referrals, and follow up with patients when equipment is due to be returned.