Referral Coordinator: Care Coordination & Prior Authorizations

The-Providence-Community-Health-Centers,-Inc.; Providence (RI); On-site; USD 42,000 - 64,000; Full time

Job summary

The Providence Community Health Centers, Inc. is seeking a Referral Coordinator in Providence, RI. The role involves coordinating referrals and prior authorizations between PCHC providers and community specialists, and supporting the care team with administrative tasks.

You will interpret insurance guidelines, monitor EHR referrals, and ensure timely processing. Strong communication and confidentiality are essential in serving diverse patient populations.

Qualifications

• Minimum of an Associate’s Degree and/or completion of a medical training program.
• Ability to navigate web portals and MS Office applications.
• Experience with referrals and prior authorizations is preferred.

Responsibilities

• Process referrals and diagnostic imaging prior authorizations during standard hours.
• Review referrals for completeness and accuracy and communicate requirements to the care team.
• Identify insurance guidelines and inform the team of testing or records needed for approval.
• Liaise with insurance companies and care teams for high‑risk referrals and status checks.

Skills

Excellent communication

Independent worker

MS Office (Excel, Word, Outlook)

Medical Terminology

HIPAA confidentiality

Experience with prior authorizations

Insurance coordination/liaison

Transportation to work

Education

Associate’s Degree or medical training program

Tools

PCHC EHR/scheduling system

Job description

The Providence Community Health Centers, Inc. is seeking a Referral Coordinator in Providence, RI. The role involves coordinating referrals and prior authorizations between PCHC providers and community specialists, and supporting the care team with administrative tasks.

You will interpret insurance guidelines, monitor EHR referrals, and ensure timely processing. Strong communication and confidentiality are essential in serving diverse patient populations.