Care Coordination & Referral Specialist

Providence Community Health; Providence (RI); On-site; USD 38,000 - 58,000; Full time

Job summary

Providence Community Health is seeking a Referral Coordinator to streamline referrals and prior authorizations, coordinating with physicians, care teams and insurers to ensure timely transfer of care and proper documentation.

The role requires strong communication, familiarity with electronic health records, and the ability to interpret insurance guidelines while serving diverse patient populations.

Qualifications

• Excellent verbal and written communication within medical contexts.
• Ability to work independently and with health care teams.
• Experience using web portals and Microsoft Office suite.
• Attention to detail and maintaining confidentiality.
• HIPAA compliance knowledge is preferred.

Responsibilities

• Process referrals and imaging prior authorizations during business hours.
• Review referrals for completeness and ensure required documents are provided.
• Interpret insurance guidelines and coordinate with care teams and insurers.
• Liaise with insurance carriers to check authorization status and escalate issues.

Skills

Referral processing

Prior authorizations

Insurance guidelines

Communication skills

Scheduling

Attention to detail

Education

Associate’s Degree

Medical training program

Tools

Microsoft Office

EHR/EMR systems

Scheduling software

Job description

Providence Community Health is seeking a Referral Coordinator to streamline referrals and prior authorizations, coordinating with physicians, care teams and insurers to ensure timely transfer of care and proper documentation.

The role requires strong communication, familiarity with electronic health records, and the ability to interpret insurance guidelines while serving diverse patient populations.