Referral Coordinator - Prior Authorization

Job Description

JOB TITLE: Referral Coordinator, Prior Authorization

STATUS: Full-Time

LOCATION: Riedman Campus

DEPARTMENT: Prior Authorization

SCHEDULE: Monday - Friday 8am - 4:30pm

SUMMARY

Referral Coordinator contributes to overall patient satisfaction by consistently delivering outstanding customer service to patients, providers and payers throughout the patient’s healthcare experience. Serves as the first point of contact for patients and physicians to coordinate services across the system. Refers to and schedules appointments, registers seminars and classes, navigates patient inquires, and communicates courteously throughout the delivery of care. Aims always for first call resolution. Collaborates with physician offices and clinical departments to coordinate services, prepares patients for their visit, and maintains all of its support processes.

RESPONSIBILITIES

• Customer Service. Provide courteous, attentive and prompt service to all those you work with and support
• Collaboration. Work well with others in different departments and organizations to deliver a seamless, exceptional customer experience
• EMR (Electronic Medical Records) utilization. Proper use of an EMR to communicate with patients, caregivers, physicians and the community to schedule patient appointments, complete registrations and respond to inquiries
• Portal management. Enroll and activate patient portal accounts, answer questions and/or resolve any user issues. 
• Acts as a key referral liaison to community provider offices, serving as a primary point of contact for private physicians to manage all types of interactions into RRHS.

Minimum Qualifications:

• Embraces a culture of customer-centric behavior and innovation critical to success in this role.
• Possesses strong customer service skills and the ability to demonstrate compassion and empathy.
• Strong verbal and written communication skills including good voice quality, good diction, and articulation are strongly preferred.
• Must be available to work a flexible schedule that may include evening, weekend and holiday shifts.
• Must be able to multitask, handling phone conversations with consumers while accurately entering data in the computer while continuing to focus on the customer.
• Proficiency in use of computers.
• Knowledge of terminology used by insurance/managed care health plans

Preferred Qualifications:

• Two (2) years customer service experience preferred, ideally in a health care setting
• Associate's degree preferred
• Prefer knowledge of medical terminology.
• Prefer knowledge of function and relationships within a hospital environment

Required Licensure/Certification Skills:

• None

EDUCATION:

LICENSES / CERTIFICATIONS: 

CHAA - Certified Healthcare Access Associate - National Association of Healthcare Access Management (NAHAM)

PHYSICAL REQUIREMENTS:

Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver’s license.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$18.00 - $23.50Rochester14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.