Referral Authorization Coordinator

Referral Authorization Coordinator

General Job Summary: The Referral Coordinator provides support to the Operations Manager with the daily operation of the centralized referral center. The Referral Authorization Coordinator serves as a key operational lead for the referral authorization function, with accountability for workflow integrity, training consistency, audit readiness, and quality outcomes. This role partners closely with leadership to establish, document, and maintain standardized referral workflows while ensuring the team is properly trained, compliant, and operating efficiently with minimal rework.

• Coordinates the work of and provides hands-on supervision of Referral Authorization Specialist to manage referral appointment requests from clinics.
• Directs all departmental activities including scheduling, staffing and daily operations as well as administrative duties such as problem resolution and quality assurance monitoring. Throughout the referral coordination process, monitors the status of referral requests and facilitates process to ensure patients secure referral authorizations in a timely manner.
• Provides support for the hiring, training, on-going supervision and evaluation of all referral coordinator staff. Coordinates and ensures the comprehensive orientation of new department team partners and assesses baseline competency. Ensures all team members are fully onboarded, trained, and consistently aligned with current workflows and payer requirements.
• Coordinates work schedules, coverage plans and assignments for referral coordinators.
• Ensures team partners follow departmental and organizational policies and procedures, including thorough knowledge of the referral appointment request process and compliance with Clinics mission statement. Reinforces adherence to standardized workflows and quality expectations.
• Troubleshoots issues and concerns related to, or from, providers.
• Maintains, monitors, and edits provider distribution list. T racks quality metrics including rework rates, audit findings, and error trends.
• Maintains oversight of audit processes, rework tracking, and quality reviews, and partners with leadership to develop action plans to address identified gaps.
• Monitors productivity of Referral Authorization Specialist. Communicate the workflow process and act as the “go to” person for Referral Specialists.
• Identifies opportunities for process improvement and collaborates with leadership to enhance efficiency, accuracy, and patient access.
• Other duties as assigned.

Requirements:

• Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required. Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.
• Completion of TB test will be required.

Education:

• High school diploma: Associate degree preferred

• Five (5) years as a Patient Care Coordinator in a medical office or healthcare facility experience
• Minimum of one (1) year as a referral coordinator preferred.
• E.H.R. and Scheduling experience
• Experience serving customers in person and on the phone.

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds
• Ability to concentrate on details.
• Use of computer for long periods of time.