Referral Coordinator Clinic (4253)

Position Summary:

The Referral Coordinator Clinic supports Trinity Health's ambulatory practices by managing all aspects of the referral and authorization process to help ensure patients receive timely and appropriate specialty care. This role processes internal and external referrals, verifies insurance requirements, secures authorizations, and coordinates the transfer of medical information to specialty providers. Working closely with clinic staff, providers, and external offices, the Coordinator monitors referral progress, communicates updates to patients and clinicians, and supports compliance with payer guidelines and organizational standards. The position functions within a collaborative, patient-focused environment where organization, teamwork, and clear communication are essential. Through accurate documentation and proactive follow-up, the Referral Coordinator Clinic promotes continuity of care and a smooth, well-coordinated patient experience.

Key Responsibilities:

• Receive, document, and process referral requests, ensuring accurate entry and routing within established clinic and payer workflows.
• Verify insurance eligibility and benefits, obtain required pre certifications or authorizations, and communicate with patients to collect needed information.
• Coordinate referral appointments with specialists or external providers, sending necessary medical records and updating patients on next steps.
• Track referral and authorization statuses in designated systems, follow up on pending items, and escalate delays or coverage concerns to the clinic manager or clinical team.
• Communicate effectively with clinicians, patients, and payer representatives to resolve issues, clarify requirements, and support care coordination.
• Maintain accurate documentation and prepare routine reports related to referral activity, authorizations, and outstanding items.

Licenses and Certifications Required:

• None required

Educational Requirements:

• Associate's degree in healthcare, business administration, or related field preferred.

Experience Requirements:

• 1-2 years of experience in health insurance referrals, eligibility, benefits, and prior authorizations preferred.
• Understanding of medical coding (ICD10 and CPT) and medical terminology.
• Strong focus on customer service, with excellent verbal and written communication skills.
• Ability to work independently, follow through on tasks, and be accountable

Special Skills or Training Requirements:

• Excellent verbal and written communication and facilitation skills.
• Ability to work effectively both independently and as part of a team.
• Strong problem solving, organizational, and time management skills.
• Proficiency with computer software and healthcare management systems.
• Ability to engage with a variety of stakeholders, including healthcare providers, community groups, and service providers.
• Strong networking and leadership skills, with the ability to manage multiple tasks and competing priorities.

Physical Requirements:

The Referral Coordinator Clinic works primarily in an office or clinic setting with extended periods of computer use, data entry, and telephone communication. Light physical activity, such as walking short distances, standing, bending, or lifting small office items, may be required. Adequate vision, hearing, and manual dexterity are essential for reviewing documents, entering information, and interacting with patients and staff.

Environmental Requirements:

Work occurs in a busy clinic or administrative environment with frequent interruptions, shifting priorities, and regular interaction with patients, clinicians, and payer representatives. The role requires sustained attention to detail, secure handling of confidential information, and adherence to HIPAA and Trinity Health privacy practices. Minimal exposure to physical risks is expected.