Referral Coordination Specialist

RIH Rhode Island Hospital; Rhode Island; On-site; USD 26,000 - 43,000; Full time

Job summary

RIH Rhode Island Hospital in Providence, RI is seeking a Referral Specialist to ensure accurate and timely processing of referrals and to coordinate scheduling within clinic guidelines.

The role focuses on reviewing referrals, updating patient demographics, insurance and authorizations, and communicating with providers to resolve coverage issues while maintaining high-quality service.

Qualifications

• Two years of clinical referral experience required and/or related experience in coding/billing and medical record operations in ambulatory care.
• Familiarity with medical records content and EHR systems.
• Spanish speaking strongly preferred; strong organizational and multitasking abilities.

Responsibilities

• Receives and reviews all incoming referrals for completeness and accuracy.
• Verifies demographics, insurance and authorizations; communicates coverage issues with providers/patients.
• Evaluates triage needs per clinic guidelines and escalates as needed.
• Documents communications in the EHR and returns incomplete referrals with reasons.
• Coordinates scheduling of referrals and appointments per protocol and prior-authorization requirements.
• Monitors referral queues and supports staff in referral record documentation.

Skills

Clinical referral experience

Customer service

Spanish language (preferred)

Education

High school diploma or equivalent

Job description

RIH Rhode Island Hospital in Providence, RI is seeking a Referral Specialist to ensure accurate and timely processing of referrals and to coordinate scheduling within clinic guidelines.

The role focuses on reviewing referrals, updating patient demographics, insurance and authorizations, and communicating with providers to resolve coverage issues while maintaining high-quality service.