Care Coordination Specialist — Referrals & Authorizations

Community Health Systems; Bullhead City (AZ); On-site; USD 42,000 - 54,000; Full time

Job summary

Community Health Systems is hiring a Clinic Care Coordinator for Western AZ Cardiology - Southwest. The role focuses on coordinating patient referrals and authorizations, working with providers and staff to ensure orders are complete and documentation is sent to referral providers.

You will notify patients of appointment details, obtain necessary authorizations, and verify insurance coverage while following HIPAA guidelines. Strong organizational and communication skills are essential.

Qualifications

• Associate degree in medical related field preferred.
• Technical school in medical related field preferred.
• 0-1 years One (1) year of experience in a medical or health-related field of work required and
• 0-1 years One (1) year of experience in a medical or health-related field of work specializing in referrals/authorizations preferred

Responsibilities

• Coordinates all incoming and outgoing referrals ordered/received by the providers in the clinic within two (2) business days of the order being submitted.
• Ensures orders are completed in the electronic health record and linked to the referral requested.
• Validates continuity of care and network integrity based on service line availability for quality patient care.
• Sends all required and appropriate documentation to the referral provider for services requested and ensures patient records are updated appropriately.
• Schedules and notifies patient of referral appointment, provides appointment information (date, time, directions, etc.), and contact information of the referral provider.
• Provides and/or obtains required authorization for services as needed and works with patient insurance to validate coverage of services; continuously follows up with the insurance company until there is resolution of the prior authorization request.
• Coordinates with appropriate staff or obtains information related to the patient’s out of pocket expense, including co-insurance and deductibles; works with patient to establish a plan to pay in advance of scheduling procedures.
• Ensures patient has information necessary to make critical care decisions and may provide information to patient caretakers in accordance with HIPAA.
• Demonstrates excellent communication and problem‑solving skills when assisting with questions or resolving problems with patients, families, and clinic staff.
• Maintains confidentiality with patient’s financial, personal, and medical information according to HIPAA.
• Follows proper chain of command and reports issues to Revenue Cycle Supervisor or Clinic Supervisor.
• Performs other duties as assigned.

Skills

Microsoft Office Suite

Athena system

Kronos

Learn new systems

Education

Associate Degree in medical field

Technical School in medical field

Tools

Microsoft Word

Excel

PowerPoint

Visio

Athena

Kronos

Job description

Community Health Systems is hiring a Clinic Care Coordinator for Western AZ Cardiology - Southwest. The role focuses on coordinating patient referrals and authorizations, working with providers and staff to ensure orders are complete and documentation is sent to referral providers.

You will notify patients of appointment details, obtain necessary authorizations, and verify insurance coverage while following HIPAA guidelines. Strong organizational and communication skills are essential.