Our business office is looking for a highly motivated Patient Services Intermediate / Referral Coordinator to join our Canton Health Center team, with a primary focus on managing and facilitating referral workflows. The Referral Coordinator will be responsible for processing incoming and outgoing referrals, including coordinating scheduling and ensuring timely follow-up to support continuity of care.
In addition to referral management, this role will be responsible for obtaining required insurance authorizations, including Global authorizations, for referred services. The position will work closely with clinical teams, patients, and external offices to ensure all referral and authorization requirements are completed accurately and efficiently.
The Referral Coordinator will serve as a key resource in navigating payor requirements, supporting appropriate documentation, and identifying opportunities to improve referral and authorization processes from both workflow and technology perspectives.
Manage and expedite incoming and outgoing referrals in a timely manner
Coordinate scheduling for referred services, including appointments, tests, and consults across specialties
Support referral and authorization needs, with a primary focus on referral coordination workflows
Verify insurance coverage and identify patient financial responsibility; assist with patient billing questions as needed
Complete all aspects of the insurance authorization process within required timeframes
Prioritize and secure required authorizations prior to service to reduce cancellations and reschedules
Process referrals in accordance with established payor guidelines, ensuring accuracy and completeness
Manage and maintain referral and authorization work queues
Serve as a resource for providers, staff, patients, and external partners regarding referral and authorization-related questions
Obtain retro authorizations for denied or rejected claims and initiate appropriate follow-up actions, documenting outcomes
Escalate complex insurance or financial concerns to Patient Financial Clearance, Financial Counselors, or appropriate resources
Support overall operational, quality, and financial goals of Michigan Medicine and the Pre-Service Revenue Cycle
Respond to patient concerns, complaints, and inquiries in a timely and professional manner
Participate in cross-training and support other office functions as needed
Perform other duties as assigned by leadership
Qualifications:
