Referral Coordinator - MARCH 2025 START - Charles River Community Health

Referral Coordinator

CLASSIFICATION/STATUS: Non-Exempt, Full Time, Permanent (40 hours/week Monday-Friday)

IMMEDIATE SUPERVISOR: Site Manager

SUPERVISORY RESPONSIBILITIES: None

FLEXIBLE WORK: In-person/ Hybrid

START DATE: March 2025

SALARY: Band 1 $19.00 -$25.00 / hour

WHO YOU ARE:

YOUR ROLE & IMPACT

The mission of Charles River Community Health (CRCH) is to partner with individuals and families so they can thrive and lead healthier lives by delivering the comprehensive, integrated, and equitable primary healthcare that matters most to them. The Referral Coordinator will work collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients, and other parties to ensure that required referral management referrals and prior authorizations for specified specialty visits and other services are obtained and appropriately recorded in the relevant practice management systems for patient appointments. The Referral Coordinator will utilize available reports to follow-up on unresolved issues and denied claims. The Referral Coordinator will also manage logistics, including appointment arrangements, transportation, and translation services and will support the Lead Referral Coordinator in managing the electronic referral system.

YOUR RESPONSIBILITIES

• Coordinate all outgoing/incoming referrals and prior authorizations.

• Check voicemails, emails, teams messages throughout day and work on EHR Inbaskets/Workqueue daily.

• Schedule referral appointments, including urgent requests, radiology exams, procedures and consultations.

• Verify insurance eligibility and submit insurance referrals and prior authorizations to ensure services are covered.

• Document appointment information on EHR, notify provider and patient with details, and mail out appointment letter.

• Prepare documentation, including office notes and labs, to fax to specialist office for upcoming appointment.

• Collaborate with the primary care provider to resolve issues related to specialist availability and patient needs.

• Process insurance referrals and prior authorizations received by fax and phone line from patients and hospitals.

• Maintain up-to-date knowledge of insurance company requirements and where patient’s insurance is accepted.

• Function as a resource for information and problem solving for patients, primary care providers, referral management program staff, specialists, and Health Center staff.

• Maintain and follows through closing the loop on all tracked referrals.

• Maintain HIPPA at all times.

• Understand the mission of the Health Center and strives to work collaboratively with Health Center staff to carry out this mission.

• Attend appropriate meetings to maintain up to date knowledge of Health Center activities and, if unable to attend meetings, follows up with supervisor for information.

• Maintain documentation to meet audit requirements and participates in audit activities as requested.

• Perform other duties as assigned by the Director of Operations/Site Manager or designee.

YOUR QUALIFICATIONS, COMPETENCIES, TRAITS

• High school diploma or GED required.

• Must have previous experience in health care setting.

• Detail-oriented with strong communication and organizational skills.

• Familiarity with referral management plans and computer skills preferred.

• Team oriented, with a strong commitment to helping others.

• Bilingual in Spanish preferred but not required.

• Ability to complete 50-60 referrals per week depending of complexity.

• Attention to details.

• Must have a willingness to work flexible hours to meet the organization's needs/demands.

• Must have excellent communication skills, particularly with people from diverse cultures, with the ability to understand the community, population, and patients we serve.

• Must have experience in diverse cultures, with strong commitment to promoting Diversity, Equity, and Inclusion and reducing inequities.

• Must believe in the work we do at CRCH, with a strong passion to serve underserved populations in diverse settings.

• Must always be able to work from home in a quiet, professional setting.

• Must have Wi-Fi/internet access at home to perform the job remotely. If you are notified in advance that there could be a disruption to your service, or there continues to be issues with WIFI you must work in the office until issues are rectified in either the Brighton or Waltham location.

WHO WE ARE & WHAT WE DO

Charles River Community Health’s mission is to partner with individuals and families so they can thrive and lead healthier lives by delivering the comprehensive, integrated, and equitable primary healthcare that matters most to them.

CRCH is a comprehensive practice providing medical, pharmacy, dental, behavioral health, optical, and vision services to diverse underserved local communities. We serve over 13,500 patients annually, and 90% of those served are low income, while over 70% need services in a language other than English.

We are committed to providing patients with timely access to the right care, at the right place and at the right time, collaborating with other organizations to connect patients with a comprehensive range of services and provide continuity of care, and creating new community partnerships to meet the changing needs of patients and the community.

We value caring for everyone with dignity, respect, and compassion, reducing cultural, financial and other barriers to care, and eliminating health care disparities for our patients. We also advocate for the needs of our patients, the community, and public health causes.

OUR PROMISE

If you are passionate about providing access to quality and compassionate care to the underserved, you will find your career rewarding and impactful. As Referral Coordinator, you will be part of a dynamic team and will find a partner in your career path goals and trajectory!

OUR BENEFITS & PERKS

Medical & Dental Insurance

Short & Long-term Disability Insurance

Generous Paid Time Off

Flexible Spending Account

Employee Assistance Program

Tickets at Work

Health Reimbursement Arrangement

Travel Reimbursement

Professional Development Opportunities

Solid track record of developing and promoting employees internally!

Charles River Community Health is strongly committed to diversity and a workplace environment that respects, appreciates and values employee differences and similarities. By providing and supporting a work culture that fosters and builds upon diversity and its strengths, CRCH will better serve our local communities and continue to provide quality patient care and services. CRCH is an employment at-will organization and an equal opportunity employer committed to maintaining a work and learning environment free from discrimination on the basis of sex, race, color, religion, national origin, pregnancy, gender identity, sexual orientation, marital/civil union status, ancestry, place of birth, age, citizenship status, veteran status, political affiliation, genetic information or disability, as defined and required by state and federal laws. Additionally, CRCH prohibits retaliation against an applicant or employee because he or she has engaged in protected activity under the statutes prohibiting discrimination in the workplace.