Referral Coordinator - Contingent Pool-OB/GYN

Trinity Health MI; Ann Arbor (MI); On-site; USD 24,796 - 30,307; Part time

Job summary

The Trinity Health Medical Group in Ann Arbor, MI is seeking a part-time Referral Coordinator. The role manages the referral process, authorizations, and follow-up to ensure timely patient care.

Responsibilities include contacting insurers for authorizations, educating patients and staff on referrals, facilitating scheduling with specialists, tracking referrals, and maintaining accurate EMR notes. Strong communication, HIPAA compliance, and proficiency with EPIC are essential.

Qualifications

• Education: High School Diploma and relevant experience in medical referrals or insurance authorizations.
• Proficient in medical terminology and HIPAA privacy guidelines.
• Strong communication skills to explain referral requirements to patients and staff.

Responsibilities

• Contacts insurance companies to obtain authorizations for specific plans.
• Educates patients and staff on referral and insurance information.
• Obtains urgent authorizations when needed and follows up.
• Assists patients in scheduling appointments with specialists and resolves referral issues.
• Generates referral information for physicians, patients and health plans.
• Acts as liaison among providers, patients and health plan administrators.
• Reviews and submits clinical information for pre-certification and referrals; monitors authorizations and denials.
• Communicates referral status to patients and physicians to align with treatment plans.
• Answers referral-related calls and outreaches to patients for appointment details.
• Verifies insurance through payor sites and notifies patients of changes.
• Tracks referrals until fulfilled; coordinates with external specialists for updates.
• Requests external notes when needed and updates EMR with authorization status.

Skills

Medical terminology

Patient communication

Multitasking

Teamwork

Education

High School Diploma

Tools

EPIC EMR

Microsoft Word/Excel

Payor portals

Job description

Position Description

This position is responsible for all aspects of the referral process, including authorizations and follow-up.

Employment Type

Part time

Shift

Day Shift

Description

This position is responsible for all aspects of the referral process, including authorizations and follow-up.

Essential Job Functions

• Contacts insurance companies via appropriate methods and obtains authorizations if applicable for specific plans.
• Educates patients and staff with pertinent referral and insurance information.
• Obtains urgent authorizations same day and next day, if needed.
• Assists patients in scheduling appointments with specialists and helps resolve referral issues.
• Generates referral information for physicians, patients and health plans.
• Acts as a liaison among providers, patients and health plan administrators.
• Reviews and submits clinical information to health plan case managers for special referral pre‑certification and out‑of‑plan or out‑of‑network referrals; monitors authorizations or denials and follows up, as necessary.
• Communicates referral status to patients and physicians; ensures that referrals have been processed accurately and in a timely manner to coincide with patient treatment plan.
• Answers incoming calls that are relevant to referrals.
• Outreaches to patients when appropriate for details on appointments and/or insurance information.
• Verifies insurance through payor sites and notifies patients if changes need to be made prior to processing the referral.
• Tracks the referrals until fulfilled by the patient, including outbound calls to patients and external specialists for updates.
• Requests external specialist office visit notes to be shared with the referring provider, when needed.
• Updates information in the patient medical record (EMR) with approval of declination of information and follows up with the primary care physician as to the status and/or issues with the referral authorization.
• Communicates with the ordering provider for next steps with practice support staff and representatives of insurance companies.
• Participates in data collection of insurance companies.
• Supports other offices, attends required meetings and training, and participates in committees, as requested.
• Assists with special projects and assumes additional duties as assigned.

Organizational Expectations

Creates a positive, professional, service‑oriented work environment for staff, patients and family members by supporting the mission and values of Trinity Health Medical Group. Must be able to work effectively as a member of the Referral Coordinator team. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management. Successfully completes all relevant organizational training and adheres to Trinity Health Medical Group standard of care as outlined in the Trinity Health Code of Conduct. Maintains knowledge of and complies with Trinity Health Medical Group standards, policies and procedures. Maintains general knowledge of Trinity Health Medical Group office services and in the use of all relevant office equipment, computer and manual systems. Maintains strict confidentiality in compliance with Trinity Health Medical Group and HIPAA guidelines. Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences. Uses resources efficiently. If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

Measured By

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

Essential Qualifications

Education: High School Diploma

Credentials/License: None

Minimum Experience: Minimum 2 years’ experience with insurance referrals, prior authorization or other relevant medical office experience.

Position Requirements (Abilities & Skills)

Knowledge of medical terminology and procedures at the level needed to perform responsibilities.

Knowledge of the compliance aspects of clinical care and patient privacy and best practices in medical office operations.

Proficient knowledge of major health plans and insurance processes.

Excellent written (legible), verbal and face‑to‑face communication skills, including ability to effectively explain relevant insurance information to patients, as well as communicate with insurance plans and internal customers. Proper phone etiquette.

Proficient/knowledgeable in patient care procedures and organizational policies related to position responsibilities.

Service‑oriented; responsive to customer needs and courteous in approach.

Proficient in operating a standard desktop and Windows‑based computer system, including but not limited to, electronic medical records, EPIC, Microsoft Word/Excel/Outlook, intranet and computer navigation.

Ability to use other software as required while performing the essential functions of the job.

Ability to compute mathematical calculations.

Ability to work independently and collaboratively in a team‑oriented environment; displays professional and friendly demeanor.

Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, patients, family members, vendors, outside customers and couriers.

Ability to cross‑train in other areas of practice in order to achieve smooth flow of all operations.

Good organizational and time management skills to effectively juggle multiple priorities and time constraints.

Ability to exercise sound judgement and problem‑solving skills.

Ability to handle patient and organizational information in a confidential manner.

Ability to travel to other office/practice sites and meeting and training locations.

Successful completion of IHA competency‑based program within introductory and training period.

Minimum Physical Expectations

Physical activity that often requires keyboarding, filing and phone work. Physical activity that often requires extensive time working on a computer. Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting. Physical activity that sometimes requires lifting, pushing and/or pulling under 30 lbs. Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

Minimum Environmental Expectations

This job operates in a typical office environment with some exposure to contagious diseases/viruses. It requires significant interaction with people (many of whom are scared, hurt and/or ill) which can be stressful and result in competing priorities.

Equal Opportunity Statement

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.